Cardiovascular diseases (CVDs) are the leading cause of death globally, taking more than 17.9 million lives each year (WHO, 2021), while within the EU 37% of all deaths in 2017 were attributed to CVDs (OECD, 2020). On the other hand, worldwide about 463 million people live with type 2 diabetes (T2D) (Roth et al., 2018) and in Europe, the number of adults diagnosed with diabetes has almost doubled over the last decade (Healthier Together, 2022). As it has been reported, CVDs and diabetes often go hand in hand (Centers for Disease Control and Prevention, 2022). For this reason, it becomes even more concerning that “the high prevalence of T2D worldwide continues to rise, even in developed European regions, and, despite significant investments in clinical care, research, and public health interventions, there appears to be no sign of a reduction in the rate of increase” (Khan et al., 2020). Moreover, T2D is now also more frequently diagnosed at younger ages, and even in children, which relates to increased overweight and physical inactivity among children, adolescents and young adults (Healthier Together, 2022).

According to OECD, on average in OECD countries, obesity (a well-recognized risk factor for the development of T2D and CVDs) will be responsible for 70% of all treatment costs for diabetes and 23% of treatment costs for CVDs. In its member countries, about one-third (32.1%) of individuals perform insufficient amounts of physical activity, whereas this value is higher in EU28 (33.1%) (OECD, 2019).

Additionally, the WHO European Region has the highest rates of smoking (WHO, 2014) and the highest proportion of drinkers (WHO, 2022a). In general, more disadvantaged groups, including the less educated and low-income individuals, are less likely to achieve sufficient levels of physical activity or have a healthy diet and they are more likely to be obese (OECD, 2019), they have higher rates of smoking (WHO, 2014) and they present elevated health risks from alcohol consumption in comparison with wealthier drinkers (WHO, 2022a). When considering “large inequalities in life expectancy exist between socioeconomic groups within and between EU countries” the challenge of reducing the prevalence of CVDs and T2D becomes even greater (Healthier Together, 2022).

On top of this, “since the outbreak of the COVID-19 pandemic, the challenge for countries to effectively prevent Non-Communicable Diseases (NCDs) has become even bigger: COVID-19 has disproportionately impacted people at risk of NCDs, among others, with a rise in unhealthy (such as malnutrition and lack of physical activity). Also, due to COVID19, the diagnosis of NCDs was forcibly postponed. The pandemic further magnified persistent inequalities in health outcomes and health determinants, both within and across countries.

Additionally, Russia’s invasion in Ukraine, which resulted in refugees arriving from Ukraine to find shelter in EU countries for a short or longer period, will also inevitably increase the burden of NCDs (Healthier Together, 2022).

On the other hand, “the COVID-19 crisis led to the accelerated introduction of some new technology by both national authorities and citizens. For instance, there has been a significant rise in the use of tele-medicine in healthcare settings and this could prove to be beneficial for the prevention and treatment of NCDs” (Healthier Together, 2022). And, most importantly, behavioural lifestyle interventions that target the four main modifiable risk factors that count for most of the burden of NCDs, i.e., lack of physical activity, poor diets, tobacco, and alcohol, have proven effective to control diabetes and reduce the risk of CVDs and this is a major opportunity that must be exploited.

Considering the above, the “PREACT” project addresses the action EU4Health Program (EU4H) in order to improve public health in the Union through disease prevention and health promotion, as well as international health initiatives and cooperations. PREACT responds to the scope and the general objectives of the call by aiming to improve and foster health in the Union and to reduce the burden of CVDs and diabetes, and related risk factors, by supporting health promotion and disease prevention, by fostering healthy lifestyles, and by reducing health inequalities.