Advancing clinical exercise physiology and integrative health policy in Tunisia: An international perspective on curriculum reform and professional recognition.

Sedentary and non-communicable diseases continue to rise in Tunisia. Yet, graduates from the country's four institutes of Sport Sciences face persistent barriers to employment and lack legal recognition within the healthcare system. Although these graduates receive academic learning and training in exercise physiology, biomechanics, adapted physical activity, and performance sciences, current legislation prevents them from prescribing exercise or working with clinical populations. Across worldwide, many countries such as the United States, United Kingdom, Australia, and Canada have established regulated pathways for Clinical Exercise Physiologists, supported by accredited university programs, national certification systems, and clear scopes of practice. Global initiatives such as Exercise is Medicine®, active in many countries, further demonstrate the integration of physical activity into healthcare; however, Tunisia, like most Middle East and North Africa countries, remains unrepresented. In this policy-oriented narrative review, we reviewed the international models and propose a strategic roadmap for Tunisia to modernize sport-science curricula, develop interdisciplinary degrees in exercise physiology, establish national accreditation and professional registration systems, authorize clinical practice, and integrate exercise into national health policy. Such reforms could reduce unemployment, enhance preventive healthcare, and align Tunisia with global standards in exercise-based medicine.