The question of whether longevity can become a new business opportunity for Italy finds an answer in a “yes, on certain conditions.” Living longer is an achievement, but it can only turn into a lever for growth if the country reorganizes healthcare, labor, and welfare around a longer life. This means investing in prevention, data, and youth. In the absence of these choices, the opposite scenario will prevail: more chronic conditions, fewer workers, and greater inequality.
Science has extended life, but it cannot guarantee the quality of those years gained. Biomedical research accounts for between 30% and 40% of the survival gains recorded since 1960, while behaviors account for 40% to 50%—achievements that are reversible, as the pandemic has shown. Research on biomarkers—meaning measurable biological indicators that signal health status, disease risk, or the pace of aging—is advancing, but none of those markers have been validated yet, meaning they cannot yet demonstrate reliability on a large scale.
The limitations of the healthcare system are evident in the struggles of emergency rooms and a weakened general practice. Prevention, predictive medicine, and data integration clash with privacy rules, which hinder the use of necessary health data. New skills—both medical and managerial—are needed, and it must be recognized that prevention is the only lever capable of acting on the demand for care, provided it is accompanied by outcomes measurement. Healthy elderly people are a new resource for the country. The ability to perform daily activities and remain autonomous matters more than the duration of life itself. Relationships are also part of health and must be supported just as services are.
On the demographic front, the decline in the active population can only be offset by a combination of different factors: higher employment among youth and women; the extension of active life; increased productivity; and effective immigration management. The window to act is approximately ten years.
A cultural shift within companies is also necessary: generational labels must be overcome, and simple handovers must be replaced with the creation of value across generations. There is broad consensus on the horizon of a longer and more flexible working life, on the need for investments in corporate welfare, and on the strengthening of supplementary forms for pensions and health. However, issues that do not admit easy answers remain open: the ways in which young people enter a labor market characterized by the pervasiveness of AI, which often replaces the very tasks where experience is built; the digital exclusion of the elderly; the causes of the declining birth rate; and the choice between equity and egalitarianism.
The changes demanded of Italy, however, must be addressed on a European scale. For longevity to become an economy, prevention—from vaccines to screenings—must be accounted for as an investment in EU budgetary rules, while tools are needed to channel family savings toward innovation. Furthermore, a distinction must be made between the silver economy and longevity, which are different markets. The former concerns goods and services for the elderly population; the latter, on the biological frontier, involves research to slow down aging and prevent its diseases. In this second field, investments are almost entirely American, and those who lack solid basic research cannot participate in it.
No less significant is the issue of resources: who bears the cost of this transformation? The healthcare system is underfunded: the response can come from increased public spending or from private capital attracted by clear public rules, but the question of how to avoid unequal access to care remains.
A public agenda that places longevity at the center can start with a few priorities. The first is to give the topic a permanent home: a manifesto and an observatory, with institutional backing. On the healthcare front, the pivot around which the system should revolve is the reform of general practice, featuring home-based care, alongside prevention understood as an investment, endowed with dedicated resources and outcomes measurement. None of this is conceivable without data. Therefore, privacy rules that allow their use for prevention and research are needed, alongside a national study that follows a large group of healthy people over time to validate biomarkers. Finally, on the labor and welfare front, the focus is on a supplementary health and pension pillar, flexible retirement transitions, and services for young people, women, and caregivers. Left outside this framework are certain particularly urgent issues awaiting adequate responses: the South and inland areas, where tailored regional policies are needed, and mental health.
In summary, longevity is an opportunity for Italy only if healthcare, labor, and welfare are rethought, all together. The time window is particularly narrow. This is why it is necessary to start with prevention, local care, and the use of data: the levers upon which consensus is broadest and where the country system shows its greatest vulnerabilities.