Chronic вЂlifestyleвЂ™ conditions such as cardiovascular disease, cancer and diabetes are taking over from infectious diseases as the primary cause of death and disability in most countries. People around the world are better educated and want more information, choice and control over their lives вЂ“ not least in the area of health. The paternalistic approach to medicine is expensive when applied to entire populations, especially in ageing countries. This paternalistic approach to medicine, supported by health systems designed to treat sickness (rather than to prevent disease) remains a familiar aspect of healthcare in many countries to this day.Д¬ircumstances and societies are everвЂђchanging, however. At the low point of selfвЂђcare вЂ“ around the 1960вЂ™s in the West вЂ“ selfвЂђcare and selfвЂђmedication were regarded as unnecessary and potentially even unhealthy practices. The role model of the patient as a largely passive recipient of public services was complemented by the mystique of the expert healing physician. Patients gratefully placed themselves into the hands of doctors and took the effective newlyвЂђdeveloped medicines they prescribed. Starting in the 19th Century and carrying on through the 20th Century, health care was revolutionized by scientific and medical discoveries, technological advances in diagnostics, surgery and medicines, and the development of the healthcare professions. The opportunity and need for improvement were great. People themselves were responsible for their own health, and that of their families, as selfвЂђsufficiency was obligatory and almost universal. Treatment involved selfвЂђmedication with locallyвЂђproduced preparations of generally uncertain efficacy. Throughout human history the dominant paradigm of healthcare was individual selfвЂђcare in the family and local community. People have necessarily managed their own health since the beginning of mankind.

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