Operation Whole Health: An Operation Warp Speed Directed at Noncommunicable Diseases

Introduction

Nations face two converging threats to health: the rising prevalence of noncommunicable diseases (NCDs) and the unsustainable growth in health spending required to manage them. NCDs are often cooccurring and chronic, amplifying their negative impact. Cardiovascular disease, cancer, diabetes, chronic respiratory illness, and back pain account for the leading causes of morbidity and mortality worldwide. ¹ More than 40 million people die annually from NCDs, and these conditions contribute to seven out of ten premature deaths. ¹ Although the United Nations established a Sustainable Development Goal target to reduce premature NCD mortality by one-third by 2030, insufficient investment in prevention and system transformation has stalled progress. ²

The economic burden of NCDs is equally alarming. In many high-income nations, total health spending now exceeds 10% of gross domestic product, even as population-level health outcomes plateau or worsen. ³ In the United States, inflation-adjusted per capita health spending increased more than 30% from 2009 to 2023, unaccompanied by gains in health status or life expectancy.^4,5 NCDs are estimated to cost the global economy $47 trillion between 2011 and 2030, driven by both direct treatment costs and indirect productivity losses. ⁶ Premature deaths and disability-related productivity losses weaken national economies, strain social service budgets, and threaten long-term fiscal stability. These pressures are similarly felt at the household level, where costs associated with NCD care impose a substantial financial burden. ⁷

While these challenges are significant, recent experience demonstrates that nations are capable of organizing extraordinary resources when a health threat is prioritized. During COVID-19, governments quickly recognized the scale of risk associated with a viral pandemic and mobilized to align political will, financing, and cross-sector capacity toward a singular goal: vaccine development, distribution, and socialization. The United States launched Operation Warp Speed, aiming to consolidate fragmented efforts, mobilize capital at scale, and coordinate public and private industries—from biotechnology to manufacturing—to accelerate a solution. ⁸ This effort is estimated to have saved over 2.4 million lives and over $6 trillion, demonstrating that when urgency is acknowledged, systemic transformation is possible. ⁹

NCDs represent a slow-moving pandemic. While lacking the urgency of the COVID-19 pandemic, the gravity and impact of NCDs warrant an analogous response. Prioritizing intentional, cross-sector, and public–private responses to NCDs is necessary to prevent further impacts on morbidity, mortality, and associated costs. The lessons from Operation Warp Speed are not purely technological, but organizational: coordinated mission, cross-sector integration, and widespread financing all accelerated transformation at scale. We propose that, in the face of the health care crisis created by NCDs, nations undertake an “Operation Whole Health”: a paradigm shift that repositions health through both personal and community engagement and the redesign of health systems and policy.

Whole Health in the Management of NCDs

Many national health systems remain rooted in a “biomedical” or “reductionist” model that views disease in isolated, organ-specific terms rather than through a holistic, whole-person lens. This approach excels in acute care and emergency interventions but is poorly suited to the slow-moving, multifactorial nature of NCDs. ¹⁰ While efforts aligned with Wagner’s Chronic Care Model have improved the management of chronic illnesses through structured, team-based care and clinical interventions, the increasing prevalence of NCDs suggests that improvements in disease management, alongside current public health prevention strategies, is insufficient. ¹¹ To combat the scale of the epidemic of NCDs, nations need a greater level of mission clarity that is currently not reflected in existing systems.

Whole health can serve as that mission priority, offering a more holistic model for addressing the multifactorial complexities of NCDs and supporting individuals across all stages of health. Defined by the National Academies of Sciences, whole health is ¹² :

A foundational objective of the proposed paradigm shift from the biomedical model to a whole health model is a change in how care is framed and delivered. This model repositions individuals at the center of their own health, a shift that moves away from care being delivered “to them” and toward care that is delivered “with them.” Through collaborative goal-setting between patients and their care team, individuals are empowered to take active roles in their health journey, employ a broader and more coordinated suite of health resources, and engage in behaviors that influence modifiable risk factors for NCDs. With scale, this transformational shift can have a ripple effect from what matters to the health of an individual, to what matters to the health of communities, to what matters to the health of the nation.

The impact whole health can have on NCDs is not merely theoretical. In the United States, the Department of Veterans Affairs repositioned their health system as one of the largest early adopters of whole health. This transformation expanded collaborative supports for Veterans and includes a transdisciplinary team of conventional clinicians, mental health professionals, and complementary and integrative health providers to support holistic care. Veterans participating in whole health services saw increases in tobacco cessation, reductions in opioid prescription use for pain management, and improvements in blood pressure and diabetes management in comparison to traditional care. ¹³ Nongovernment health systems, including Cleveland Clinic Center for Functional Medicine and Kaiser Permanente’s Integrative Medicine Program, have also implemented whole health projects to help address chronic NCD management.^14,15 Integrating a range of health care practitioners and services, these programs have demonstrated improvements in clinical outcomes, cost-effectiveness, and replicable framework for larger-scale implementation.

With lessons from these documented successes, additional measures could be taken to further scale a paradigm shift toward whole health. However, cultural, policy, and financing constraints have limited its implementation. ¹⁶ As NCDs continue to drive morbidity, mortality, and health spending, whole health should be viewed as the mission-critical approach to transform the health of individuals, communities, and health systems.

Integration of TCIM to Grow Capacity

For whole health to function as a national strategy for addressing NCDs, workforce capacity must be deliberately expanded. In the United States, primary care emphasizes the diagnosis and treatment of disease; however, the overwhelming prevalence of NCDs limits the capacity of primary care to engage with patients on prevention and early-stage disease management. ¹⁷ On the other hand, public health systems are equipped to implement population-level policies, but are not structured to provide individualized, relationship-based prevention. ¹⁸ The result is a persistent structural gap, with treatment-oriented clinical care on one side and population-level intervention on the other, with insufficient integration to support sustained prevention.

To properly address the prevention and early-stage management of NCDs, a workforce that can provide sustained engagement at scale is required. One mechanism to expand workforce capacity is the systematic integration of traditional, complementary, and integrative medicine (TCIM) practitioners. Their training emphasizes nutrition, physical activity, stress regulation, lifestyle counseling, and relational care—domains central to NCD prevention. ¹⁹ In contrast to conventional providers, TCIM practitioners routinely engage in longitudinal care and visits outside the time constraints of systems, which can support behavior change and patient activation. ²⁰ These functions complement, rather than replace, conventional medical management and help operationalize prevention efforts through relationships that encourage healthy behaviors.

Despite this alignment, TCIM professions remain largely excluded or siloed from conventional health systems. ²¹ Although many nations regulate TCIM providers, public and private insurance coverage is limited. Consequently, few health systems integrate them into mainstream care delivery, population health planning, or national workforce strategies. Moreover, there are limited models that demonstrate how TCIM professionals can be systematically leveraged to expand prevention capacity or manage NCDs at scale. ²² This exclusion constitutes a structural inefficiency: a prevention-trained workforce remains underutilized even as NCD rates climb and health care systems face mounting shortages of conventional providers. Significant reforms are necessary to embed TCIM into whole health systems at the appropriate scale.

Financing to Deliver Whole Health

One defining feature of Operation Warp Speed was widespread, coordinated public financing to drive workforce coordination and align cross-sector priorities around a shared goal. Focusing financial structures around a shared priority accelerated innovation and reduced historical barriers that previously siloed work and stalled coordination. In Operation Whole Health, a similar approach to financing would be needed to align cross-sector efforts on NCDs. For example, in a whole health system, patients with chronic back pain could receive evidence-based symptom management from a chiropractor or acupuncturist, engage in group exercise with their neighbors at their local community center, address fear of movement with a behavioral health provider, and initiate smoking cessation with the support of public health services. This whole health approach provides individuals with the knowledge, support, and resources needed to manage their condition holistically, while reducing the risks and costs associated with NCDs.^23,24 Health care financing would need to be restructured to accomplish this and may include the following: health care for all; the inclusion of TCIM and lifestyle medicine in public and private health care plans; interoperable electronic health systems that knit together health care, social support, and public health interventions; and investment in community infrastructure. In contrast, within existing health systems, this same example of a patient with chronic back pain faces a complex and fragmented pathway of managing insurance coverage, siloed providers, high levels of out-of-pocket spending, and a limited focus on prevention. This often results in the provision of high costs, low-value services, and poor outcomes. ²⁵

Within a whole health system, financing would support coordinated care that integrates services beyond conventional clinical services. Funding should be earmarked to integrate and coordinate cross-sector individual- and community-care plans to prevent and manage NCDs. Increased investments in early intervention providers, public health initiatives, and community-based efforts that address determinants of health are needed to shift individual, family, and community culture around modifiable risk factors.

Economic analyses reinforce this approach. The World Health Organization estimates that 60%–80% of NCDs could be prevented through sustained interventions targeting diet, physical activity, and tobacco use. ²⁶ These strategies are highly cost-effective, with every $1 invested generating approximately $7 in economic benefit through reduced health care spending, lower disability rates, and increased productivity. ²⁶ As Operation Whole Health seeks to transform the health system, a substantial component of this operation will require funding workforce expansion, infrastructure, research, and implementation of this mission.

Toward an Operation Whole Health

Redesigning national health systems will demand an “all hands-on deck” approach that aligns patients, clinical providers, public health professionals, community organizations, and prevention-trained disciplines within unified care models. The scale of this effort must meet the scale of the impact and costs of NCDs. To guide nations toward an Operation Whole Health, actionable steps include:

Invest significantly in whole health research and implementation, prioritizing pragmatic trials, implementation science, and real-world evaluation to rapidly identify, refine, and scale prevention-focused models of care.

Conclusion

The 2030 global NCD targets are rapidly approaching, yet current trajectories suggest they will not be met under existing policy frameworks. Achieving meaningful reductions in premature mortality will require a paradigm shift rather than incremental reform. Analogous to the rapid reconfiguration seen during Operation Warp Speed, an Operation Whole Health is needed to expand prevention capacity and improve whole-health delivery to address NCDs. By transforming the current system to a whole health paradigm, financed and delivered at scale to both individuals and communities, the United States can deliver a model of care that can sustainably improve the health of nations. The evidence base exists. In many places, the workforce exists. The structural levers are identifiable. The remaining question is whether national leaders and existing systems will commit to the cultural and system transformations needed to address a slower, but more persistent, pandemic.

Authors’ Contributions

R.R.B.: Conceptualization, writing, and editing. M.J.M.: Conceptualization, writing, and editing. A.K.A.: Conceptualization, writing, and editing. C.E.S.: Conceptualization and editing.