In 2009, Professor Thom McKenzie famously wrote that ‘School Physical Education was the Pill not taken’. For 60% of citizens in Europe, Sport and Physical Activity and Physical Education represent the ‘Pill not taken’. In 2013, the World Health Organisation outlined compelling evidence that increasing levels of physical activity and reducing sedentary behaviours would lead to a range of health benefits for an individual across their lifespan. Population behaviour change in sport and physical activity can be developed through knowledge exchange and enacted through a hybrid architecture of bottom-up and top-down approaches to policy and practice (Savarimuthu, Le & Ghose, 2012, p.1). In this paper, a new all-island, multisectoral initiative is described: All Island All Active (AIAA). It aims to enhance the quality and effectiveness of sport and physical activity in a variety of contexts in order to increase physical activity levels and reduce sedentary behaviours in citizens by 2025 [based on the World Health Organisation (WHO) Physical Activity guidelines]. To do this, AIAA employs a hybrid architecture of academics, policy makers and practitioners, and the community and voluntary sector to help enact physical activity policy across the Island of Ireland.