Prevention and innovation are key instruments in building a more efficient, equitable and resilient healthcare system. The countries of Europe, and Italy in particular, are faced with a range of challenges. At the European level, health represents 15% of public spending and 9% of gross domestic product (GDP), of which the public component is around 7%. However, with the growing demand for health services resulting from the ageing of the population, a re-thinking of the system is needed to ensure that it remains sustainable. Health costs are in fact estimated to rise by 10-20% in the coming years.
In a fragmented global system that poses significant challenges, the World Economic Forum’s Global Risks Report 2025 ranks Italy among the countries with the highest risk of social fractures and inequalities, partly as a result of the country’s high percentage of over-65s. Ensuring that the population has equitable access to treatment and wellbeing is therefore essential for the future.
The responses to these challenges include a rebalancing of hospital care and locally-based treatment, more efficient procurement practices and the adoption of digital technologies to monitor health services. Impact measurement is particularly important, while an efficacy-certification system could facilitate the validation of new healthcare models and as a consequence improve innovation funding. Some regions, in cooperation with the Ministry of Health, are already trialing new models to improve access to innovations in the health sphere. In addition, the opportunities opened up by scientific discoveries and personalized medicine require investment if they are to be accessible to all and the universal nature of the country’s health system maintained. Generating a virtuous circle here would also support Italy’s excellent research sector and help it recover ground in technology transfer.
The European Union (EU) supports Member States by monitoring national policies (exchanges of best practices and recommendations) through funding and specific programs. For the 2021-2027 period, for example, 50 billion euros have been allocated, to which can be added 40 billion linked to the National Recovery and Resilience Plan (PNRR). And yet the most significant contribution, for a highly indebted country like Italy, could come from its accounting system: the New Economic Governance Framework (NEGF) views the term “investment” in a new light, as a means of using to better effect those budget items which over the long term will generate more growth and lower costs. As in the defense, digital and energy transition spheres, prevention in the health system can also be viewed as a strategic investment.
Investing in prevention generates an extraordinary economic return, of 44 euros for each euro spent. The benefits in terms of productivity and the welfare and wellbeing of the population can be produced without any significant increase in financial resources, by allocating them more effectively. Italian health spending is extremely unbalanced: 95% of resources currently go to treatment, and only 5% to prevention. The Ministry of Health aims to raise the latter to at least 7-8%.
The first step concerns the health culture and mindset. Initiatives should focus, for example, on immunization and screening, and on key risk factors such as smoking and childhood obesity. In addition, the sharp differences currently seen in Italy’s regional data require attention and analysis.
To stimulate the debate on the new healthcare paradigm – no longer reactive, i.e. pathology-based, but proactive – it will be necessary to raise public awareness and that of Italian and European decision-makers. At the national level, both the economic and the cultural dimensions of prevention need to be taken forward through legislative initiatives in the short term, while the prevention of illness needs to be viewed, in the National fiscal-structural plan, as a strategic investment. Turning to Europe, investment in crucial practices such as immunization, the effects of which can benefit all European countries, should be supported. Economic and social resilience, especially in the health sphere, is, moreover, one of the four priority areas on which the action of the EU’s institutions is focusing in its vision of a future of wellbeing and prosperity for the continent.