The PRECISION MEDICINE ALLIANCE (PMA) promotes PRECISION MEDICINE FIRST and has the substantial goal that the Alliance will build a very strong PRECISION PREVENTION FIRST approach by organizing a sustainable outcome-oriented PMA-Cycle. Today the Cycle starts realistically with the molecular diagnosis of a tumor, tomorrow we want to be at the forefront towards Precision Prevention as the sustainable start of the PMA-Cycle. Though clinical reality today is quit often that Precision Medicine is the last try in complex cases, even their are reports about cases when molecular diagnostic happened in at the very latest stage in the hospice and with help of Precision Medicine there are even reports that this hopeless cases could get a precise treatment found prolonging the patients live instead of let him die. This unethical approach should be changed by developing an PRECISION PREVENTION FIRST approach in the near future for a longer health span in longer living societies in a better performing health system: