THE LANCET SERIES TWO ON PHYSICAL ACTIVITY: The cost of physical inactivity reflects global failure to implement prevention strategies

Commentary from the ISPAH President

The latest evidence on the risks and costs of too little exercise are published in a special series of The Lancet launched this week to coincide with the forthcoming opening of the 2016 Olympic Games ( Across four papers, new data are presented on the large costs incurred by national health care systems due to physical inactivity, the potential of regular activity to protect against cognitive decline and the additional health risks associated with excessive time spent sitting. The series reaffirms the importance of promoting regular physical activity across all ages and yet closes with the damning conclusion that there is minimal evidence that physical activity is improving worldwide.

Under the mandate of the UN Declaration on NCD prevention (2011) countries are working towards achieving a reduction in preventable deaths due to NCDs by 2025 and one of nine global targets is to reduce physical inactivity by 10% by 2025. This goal is unlikely to be achieved by any country if present level of effort continues. Worse, many countries could go backwards with levels of sitting and inactivity increasing as the drivers of these behaviors continue to negatively impact on daily lives.

Action is possible and the 2025 target is achievable but only if countries prioritise and implement, at scale, effective strategies. The new Lancet Series reports an increase in evidence on effective interventions, particularly from low and middle countries which are recognized to face multiple challenges in responding to physical inactivity including resource constraints, fragile health care systems and limited workforce capacity. Also, the Lancet Series reports new data on the status of national physical activity policies, but the authors conclude there is a general failure to implement these policy and scale up interventions to achieve discernable population level change.

The Lancet Series authors, like others such as ISPAH, highlight that achieving the “10x25” physical activity goal will require more commitment, leadership and resourcing. This was recognized at the recent 69th World Health Assembly (WHA, 2016) with countries calling for an increase in international effort. The Ministry of Health, Thailand, writes in their Commentary on the Lancet Series that more needs to be done to foster global collaboration and improve our monitoring of countries commitments to achieving 10x25. Talk is not enough. Thailand’s experience in promoting physical activity typifies many countries around the world, and their recent call for countries to join in the development of a Resolution on Physical Activity at 70th WHA is timely. ISPAH is focused on supporting WHO and all countries in their efforts to research and translate evidence into practical public health strategies to increase physical activity. In November at our 2016 ISPAH Congress we will showcase the latest research from around the world and, with WHO as our official co-sponsor, the global physical activity policy agenda will be at the forefront of discussion. Join us at

Professor Fiona Bull

President ISPAH