On 16 December, the European Commission published the EU Safe Hearts Plan, the first comprehensive EU-wide strategy dedicated to cardiovascular health. EuropeActive, together with its National Association members, welcomes the publication of the Plan and acknowledges it as a major milestone in the EU’s response to cardiovascular disease (CVD), following our collective contribution to the Commission’s Call for Evidence in September 2025.
Cardiovascular diseases remain the leading cause of death and disability in the European Union, claiming 1.7 million lives every year and affecting an estimated 62 million people. Beyond the devastating human impact, CVDs impose an annual economic cost of over EUR 282 billion, including EUR 47 billion in lost productivity. Without decisive preventive action, the situation is expected to worsen significantly: between 2025 and 2050, the prevalence of cardiovascular diseases is projected to rise by 90%, with deaths increasing by 73.4%.
Against this backdrop, the Safe Hearts Plan represents a timely and much-needed strategic response. Its three pillars - prevention, early detection and screening, and treatment and care including rehabilitation - supported by cross-cutting actions on digital innovation, research and tackling inequalities, reflect a comprehensive understanding of the cardiovascular patient pathway and the need for EU-added value.
Strong recognition of prevention and physical activity
EuropeActive particularly welcomes the Plan’s recognition of prevention as one of its three main pillars, rightly identified as the most cost-effective way to address the cardiovascular disease burden. Nearly 80% of cardiovascular diseases are preventable through lifestyle changes, yet prevention still accounts for only around 3% of total healthcare spending in the EU. This imbalance is clearly unsustainable in the face of rising disease prevalence and mounting pressure on health systems.
From the perspective of the fitness and physical activity sector, it is encouraging that the Safe Hearts Plan explicitly recognises physical inactivity as a major modifiable risk factor for cardiovascular disease. The Plan acknowledges that over 25% of the EU population does not meet sufficient levels of physical activity, while among children and adolescents the situation is even more alarming: fewer than 1 in 5 boys and 1 in 10 girls aged 5–17 meet the WHO’s recommended levels of physical activity.
The Commission’s commitment to:
- proposing an update of the Council Recommendation on health-enhancing physical activity across sectors,
- strengthening awareness of the link between physical activity and cardiovascular health through EU-wide campaigns such as #BeActive and the European Week of Sport, and
- continuing EU funding for physical activity through programmes such as Erasmus+ and EU4Health,
is a positive signal that physical activity is increasingly recognised as a cornerstone of cardiovascular disease prevention and overall public health.
EuropeActive also welcomes the Plan’s focus on children and young people, recognising that prevention must start early in life. While rising obesity, increased screen time and declining physical activity levels continue to pose serious long-term risks for cardiovascular health, encouragingly, many young people - particularly those from Generation Z - are increasingly engaging with gyms and organised fitness activities such as group classes. Gyms are no longer seen solely as training facilities, but as social and community spaces that support both physical and mental wellbeing. Growing participation in structured physical activity helps young people reduce sedentary behaviour and time spent on screens, while fostering social connections, confidence, and a sense of belonging. Early intervention through education, community engagement and access to inclusive fitness opportunities is therefore essential to establish lifelong healthy habits.
A missing piece: targets, milestones, funding and implementation for reducing physical inactivity
While EuropeActive applauds the Commission for clearly recognising the role of physical activity in cardiovascular disease prevention, the Safe Hearts Plan falls short in translating this recognition into concrete, measurable and adequately resourced action. Despite physical inactivity being at unacceptably high levels across the EU, the Plan does not set:
- EU-level targets for reducing physical inactivity,
- clear milestones or timelines to monitor progress and ensure accountability,
- a dedicated implementation roadmap outlining how physical activity policies will be scaled up across sectors such as health, education, sport, finance and urban planning, nor
- additional funding mechanisms or investment to support the large-scale delivery of physical activity interventions.
Moreover, the Plan’s approach relies heavily on communication and awareness-raising activities to promote physical activity across the EU. While EuropeActive fully recognises - and actively delivers - such initiatives through the annual #BEACTIVEDAY campaign, the evidence shows that communication alone cannot address Europe’s growing physical inactivity and NCD challenge. The 2025 #BEACTIVEDAY campaign achieved the highest impact since its launch, with 22 participating countries, 25,778 events organised, 829,707 participants engaged, and a communication reach of 13.6 million people. These results reflect the exceptional commitment of national associations and local organisers, as well as the growing recognition of physical activity as a cornerstone of public health, with this year’s focus on Health-Enhancing Physical Activity (HEPA), the role of exercise in improving health outcomes, and the inclusion of people living with non-communicable diseases (NCDs).
However, the Plan’s strong reliance on awareness-raising is not matched by the introduction of new, concrete policy measures or dedicated funding to meaningfully reduce physical inactivity. Awareness of the benefits of physical activity continues to grow across the EU, yet inactivity levels remain persistently high. Further campaigns alone - however successful - are therefore unlikely to deliver meaningful, long-term change. What is urgently needed are well-resourced interventions that address the structural and socio-economic determinants of inactivity, reduce inequalities in access to physical activity opportunities, and embed physical activity more systematically across health, education, finance and urban planning.
Without measurable objectives, clear implementation mechanisms, and appropriate investment, there is a real risk that physical activity remains acknowledged in principle but under-delivered in practice. This is particularly concerning given the scale of the challenge: insufficient physical activity continues to undermine cardiovascular disease prevention and management efforts, widen health inequalities, and drive avoidable healthcare costs. The lack of targeted action is particularly concerning for vulnerable groups, who face alarmingly low activity levels and limited access to opportunities for physical activity, making tailored, supportive, and inclusive approaches urgently necessary.
In this context, the planned revision of the Council Recommendation on health-enhancing physical activity (HEPA) in 2027 represents a crucial opportunity to move from awareness to action. To be effective, this process must meaningfully involve the fitness and physical activity sector, whose expertise, infrastructure and reach are essential to fostering practical, scalable and impactful solutions capable of delivering sustained behaviour change across Europe.
