The past year has brought global health financing to the forefront of conversations, igniting a search for diversified sources of funds. Large financial assessments effectively communicate the urgency of the moment. For example, global obesity costs are expected to reach $4.32 trillion annually by 2035, and cardiovascular disease, or CVD, costs are predicted to rise to just over $1 trillion by 2030.
On the other hand, estimates of the financial returns from prevention efforts are promising: For example, every $1 invested in noncommunicable disease, or NCD, best buys in lower- and middle-income countries is likely to result in a return of $7, generating $230 billion by 2030 and saving 7 million lives.
Although hopeful, these estimates are rarely accompanied by a reliable formula for securing such gains. And, without specific steps toward implementation, they may understandably lead policymakers and stakeholders to view such projections with caution.
The economics of implementation science
While it is critical to generate research that allows for economic approximations — and equally critical to develop clinical best practices — the advance of NCD prevention and treatment is wholly dependent on effective implementation science. Implementation science evaluates strategies to support the uptake of research and evidence-based practices, or EBPs, into practice and policy. As noted in an August 2025 report, “It is not enough to know that an intervention is efficacious/effective; to affect population health, knowledge of implementation strategies that are effective, sustainable, and scalable is needed.”
Structured and consistent economic planning — in other words, understanding and budgeting for the costs of implementation — is key to ensuring the transition from trial to practice is both initiated and executed. Yet research shows there is little consensus about what qualifies as an implementation cost, especially in interventions based in lower- and middle-income countries, greatly complicating the budgeting process.
The disconnect between research and real-world application has the potential to erode policymakers’ trust, leaving them less willing to implement policies — even those that have been proven to transform NCD care. Economic evaluation and implementation science must come together to create frameworks that will deliver cost-effective, lifesaving care around the globe.
Implementation science for improving health
In addition to expanding our ability to answer economic questions, implementation science can promote the inclusion of principles that drive equitable health by advocating for systems and outcomes that uplift all communities. Embedding these principles into evolving systems of care is essential to improving population health and maximizing the impact of investments.
Effective EBPs may be applied across various sectors of the health care system. But achieving scalable and sustainable impact requires theoretical frameworks that comprehensively examine the barriers, facilitators, and processes that affect implementation.
The opportunity for population and system impact
An immediate opportunity to integrate the frameworks of cost-effectiveness, implementation science, and equitable health to reduce the growing burden of NCDs is through the concept of cardiovascular-kidney-metabolic, or CKM, syndrome. CKM syndrome is a health disorder attributable to connections among obesity, diabetes, chronic kidney disease, or CKD, and CVD, including heart failure, atrial fibrillation, coronary heart disease, stroke, and peripheral artery disease. In addition to CVD and diabetes, CKM syndrome presents clinical challenges for other NCDs such as cancer, brain health and cognitive decline, and liver disease.
Capitalizing on this opportunity for integration, the American Heart Association developed a CKM screening and staging construct for both adults and youth. It aims to provide early detection and treatment guidance, with a focus on patient-centered, interdisciplinary care across the CKM disease stages. Novel in its attention to current clinical care guidelines, the CKM construct — combined with consideration of social drivers of health, such as income or education level — can aid health care systems in identifying and addressing barriers to quality care through data-driven evaluation. This, in turn, can help to diagnose, monitor, and treat patients by identifying biomarkers, symptoms, and progression patterns unique to CKM. The Association’s Get With The Guidelines™ registry provides a framework for health care systems to rapidly implement key CKM health measures. It also enables evaluation of center-specific performance using registry-based data, providing the opportunity to leverage and scale a well-developed learning health system implementation science framework.
Multistakeholder action for optimizing resources
Just as health is shaped by many factors, fully implementing this approach requires multistakeholder action to adapt and localize EBP tools and programs and leverage existing assets, unlocking the health and economic benefits that are within reach. In order to follow the CKM screening and staging construct, it is important to have a guide to bridge the gap between research and clinical practice — an implementation science road map. Putting such a road map into practice for CKM syndrome prevention and management will require:
• Addressing barriers such as fragmented health care delivery systems, affordability, and access to pharmacotherapies.
• Eliminating knowledge gaps in research, and improving education for both clinicians and the community.
• Integrating CKM screening and staging for youth and adults.
• Evaluating system-level integration and impact on patient outcomes.
Encouraging health care systems and governments to champion this patient-centered implementation focus for CKM syndrome is a key step toward reducing disease burden across multiple NCDs, improving health system and provider efficiency, and supporting a stronger, more sustainable workforce.
No matter your role in the health care continuum, you have a part to play in transforming CKM health. Answer the call to action here.
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About the authors
Melanie Turner
Melanie Turner is the international health science executive at the American Heart Association whose mission is to be “a relentless force changing the future of health for everyone everywhere.” Melanie has worked with the association since 2001 and, in her current role, works with global partners to develop and implement programs addressing needs in cardiovascular professional education, quality improvement, and scientific research.
Caroline McLeskey
Caroline McLeskey is a graduate student at Brigham Young University School of Public Health studying Healthcare Administration. She is an intern for the American Heart Association focusing on global health research.
