A sweeping new analysis from Washington University in St. Louis has found that global progress to promote physical activity — a proven driver of better health — is in danger of stalling or reversing. Shrinking public health budgets, fraying international cooperation and surging military spending are siphoning resources away from prevention efforts.
The paper, “Global Progress in Physical Activity — Gains and Growing Threats,” was published in the July 2025 print issue of the Journal of Physical Activity and Health and authored by Rodrigo S. Reis, a professor at the WashU School of Public Health. Reis reviewed six decades of global physical activity research, policy and practice.
“The world has built a foundation for active, healthier societies,” Reis said. “We must not let short-term political priorities erode long-term health gains.”
Major gains — and a fragile foundation
Researchers have demonstrated the strong links between regular movement and improved physical and mental health, prompting a wave of international action. Regular physical activity is recognized as one of the most cost-effective ways of preventing chronic disease, particularly in low- and middle-income countries, where such diseases are on the rise. Today, more than 80% of countries report having national health campaigns or policies that promote movement.
The World Health Organization (WHO) launched a Global Action Plan in 2018 to reduce physical inactivity by 10% by 2025. That goal has not been met — and now, with inactivity on the rise, the plan is not on track to reach its broader target of a 15% reduction by 2030. The plan encourages governments to integrate activity into schools, urban design and disease prevention strategies — from adding sidewalks and bike lanes to embedding movement into curricula.
Collaborative efforts have helped scale this progress across borders. Countries now share data, success stories and tools to monitor physical activity and guide policymaking. Landmark efforts such as The Lancet’s Physical Activity Series have further elevated the issue, helping drive change across continents.
Emerging threats
But Reis’ analysis found that progress is under growing threat. Rising geopolitical tensions, economic pressures and budget cuts are undermining global cooperation and investment in health promotion.
In 2024, global military spending soared to $2.46 trillion — a 7.4% increase from the previous year, the study found. Research shows that for every 1% increase in military spending, health spending drops by about 0.62% on average — with low-income countries hit hardest.
Recent examples:
- The European Union diverted €2.1 billion ($2.25 billion U.S. dollars) from its Horizon Europe research and innovation program — with €1.5 billion redirected to defense.
- The United Kingdom, France, the Netherlands and Belgium slashed health and development aid to prioritize national security.
- The U.S., once the largest global health funder, has pulled back from foreign aid. Agencies such as the National Institutes for Health and the Centers for Disease Control and Prevention now face tighter budgets and increased competition for international grants.
This shift, Reis, said, threatens to unravel global progress on chronic disease and sedentary lifestyles — especially in countries already struggling with health infrastructure. About 6.3 billion people — the vast majority of the world’s population — live in countries where efforts to promote physical activity remain insufficient, he said.
Global collaboration under strain
Reis also warned that the collapse of international cooperation is weakening global physical activity promotion. Since the war in Ukraine, Russia’s research output and cross-border partnerships have plummeted. Meanwhile, tensions between the U.S. and China, once close collaborators in health research, are disrupting scientific exchange. China’s partnerships with other countries also have declined.
A rise in “scientific nationalism” — where nations prioritize domestic research agendas over global collaboration — is making it harder to maintain shared knowledge systems, he said. Cuts to academic exchanges, joint projects and conference travel are further straining ties.
Yet it is through these partnerships that low-income countries have been able to launch successful programs. Nearly half of all countries have maintained or improved their ability to monitor physical activity trends and implement supportive policies, Reis noted.
A silent pandemic
Physical inactivity contributes to an estimated 5 million preventable deaths each year, putting it on par with the leading causes of death, such as smoking, high blood sugar, high blood pressure, air pollution and infectious diseases. Unlike the swift, unified action seen for pandemics, the fight against inactivity remains fragmented and underfunded.
“Physical inactivity is a global challenge that no country can solve alone,” Reis said. “We must recommit to a vision of health that crosses borders and benefits all.”
He urged renewed global cooperation, protection of public health budgets and prioritization of prevention to preserve gains and reach the WHO’s targets. “Letting health promotion slip off the agenda would have long-term consequences for billions of people,” he said.
