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00925njm 22002777a 4500 dc Taruscio, Domenica author Bermejo-Sanchez, Eva author Salerno, Paolo author Mantovani, Alberto author 2019 Protection of early development contributes to health of next generations. Congenital anomalies (and other adverse reproductive outcomes) are an important public health issue and early indicator of public health risks, as early development is influenced by many risk factors (e.g., nutrition, lifestyles, pollution, infections, medications, etc). Effective primary prevention requires an integrated "One Health" approach, linking knowledge and action. This requires surveillance of health events and potential health-damaging factors, science-based risk analysis, citizens' empowerment and education of health professionals. From the policy standpoint, joint budgeting mechanisms are needed to sustain with equity intersectoral actions (involving policy domains of health, social affairs, education, agriculture and environment). States should devote resources to strengthen registries and systematic data collection for surveillance of congenital anomalies, to better inform national prevention strategies. Investing in primary prevention based on scientific evidence is essential to support sustainable and resilient health systems and sustainable development of the society. Ann Ist Super Sanita. Jul-Sep 2019;55(3):258-264. 10.4415/ANN_19_03_11 2384-8553 Annali dell'Istituto superiore di sanita 31553320 http://hdl.handle.net/20.500.12105/11090 Primary prevention as an essential factor ensuring sustainability of health systems: the example of congenital anomalies