The Italy Ministry of Health and Italy Ministry of Sport and Youth have jointly unveiled data demonstrating that government spending on sports infrastructure and physical activity programs is delivering measurable savings to the national health system—transforming exercise from a lifestyle choice into a formal tool of medical prevention. Speaking at a Sport e Salute conference in Rome, Health Minister Orazio Schillaci framed the argument in stark fiscal terms: "If we want to maintain a national health system like ours—one appreciated abroad—we must reduce the future number of sick people."
Why This Matters
• Healthcare savings: Every euro invested in sports generates more than 8 euros in community benefits, with nearly 4,000 fewer diabetes cases and 8,700 avoided coronary heart disease cases attributed to increased physical activity.
• Sedentarism hits record low: The proportion of inactive Italians has fallen to 33.2%, down from over 2 million sedentary citizens between 2019 and 2025.
• Medical prescription now mainstream: Doctors can now formally prescribe structured exercise and adapted physical activity (AFA) as part of treatment protocols for chronic conditions, including diabetes, hypertension, and obesity.
• Infrastructure push in the South: Over 1,000 playgrounds have been built across southern Italy, with 85 municipalities receiving funding under the "Sport Illumina" program for modular sports spaces by September 2026.
From Theory to Treatment: Exercise as Prescription
The Italy Ministry of Health has formalized two distinct pathways for medically prescribed physical activity, both now embedded in the National Prevention Plan running through 2025 and being extended into the next cycle to 2029. These are Adapted Physical Activity (AFA) for people with chronic health issues and Structured Physical Exercise (EFS) for those with stable, exercise-responsive conditions.
General practitioners, pediatricians, and specialists can now prescribe AFA courses—group sessions led by sports science graduates or physiotherapists designed to improve quality of life for people with long-term health problems. EFS, meanwhile, is a more intensive regimen for conditions like Type 2 diabetes, high blood pressure, COPD, and certain cancers, conducted in regional "Health Gyms" where kinesiologists work alongside sports medicine physicians.
The updated Ministry of Health guidelines, revised in November 2024, now include recommendations for people with musculoskeletal diseases and those who have undergone organ transplants. A 2025 consensus document from the Italian Federation of Sports Medicine (FMSI) and the Italian Society of Sports Cardiology (SICSport) further codified the role of exercise in cardiovascular disease prevention and treatment.
The Economics of Prevention
Marco Mezzaroma, president of Sport e Salute, described sports funding as "the lowest-cost medicine for the state," citing 3.16 billion euros invested between 2019 and 2025 for a population of 12 million active participants. The return on that investment is quantifiable: 93,000 fewer cases of depression, savings of nearly 12 million euros from diabetes prevention alone, and an additional 12.2 million euros saved by reducing coronary heart disease incidence.
The Italy National Health Service (SSN) currently spends roughly 180 to 193 euros per capita on prevention—well below Germany's 458 euros and Austria's 411 euros—and only 4% to 6% of total health spending goes to preventive measures, compared to a European average of 6.5%. Yet the cost of inaction is steep: physical inactivity costs the SSN 6.7 billion euros annually, and chronic diseases affect 24 million Italians at a total cost exceeding 65 billion euros per year.
Health Minister Schillaci underscored the urgency during his remarks: "We are the second most long-lived nation in the world, but we are not the second largest economy. We must focus on correct lifestyles and prevention. Many diseases are preventable—many cancers are preventable. We must live longer, but above all, we must live better."
Studies presented at the Rome conference suggest that if just 1% of the population began 150 minutes of moderate physical activity per week, the SSN could save 223 million euros annually. Scaling that to a 10% increase in national sports participation could reduce health system costs by 1.6%.
Building Infrastructure Where It's Needed Most
The Italy Department for Sport, under Minister Andrea Abodi, has embarked on an infrastructure campaign targeting underserved areas, particularly in the southern regions. Over 1,000 playgrounds have been constructed in the Mezzogiorno, and the "Sport Illumina" initiative aims to complete 100 modular, inclusive sports spaces nationwide by September 2026. With a budget exceeding 30 million euros, 85 municipalities have already been awarded funding—including Latina, which received 320,000 euros for a new playground. Sport e Salute will handle maintenance and management of these sites.
The broader "Sport e Periferie" fund has allocated 110 million euros in 2025 for the rehabilitation and construction of public sports facilities, with more than 40% earmarked for the South. Municipalities with populations over 5,000 can apply for up to 1.5 million euros for facility upgrades; larger cities with over 15,000 residents can request up to 3 million euros for sports halls. The application deadline for the 2025 round was 16 June, and 1,037 proposals were submitted.
Under the National Recovery and Resilience Plan (PNRR), 700 million euros have been dedicated to sports infrastructure, again with over 40% directed to the Mezzogiorno. A specific 12 million euro call targeted small southern municipalities (under 10,000 residents) for indoor facilities, with projects required to finish by 30 June 2026. The PNRR aims to issue at least 100 completion certificates for sports infrastructure projects by that date.
The Behavioral Shift
Data from ISTAT show a steady climb in sports participation: from 26.6% in 1995 to 37.5% in 2024, with continuous participation rising from 17.8% to 28.7%. The 2025 Sports Report, published in January 2026 by the Institute for Sports and Cultural Credit (ICSC) and Sport e Salute, confirmed that 38 million Italians are now physically active—roughly two out of every three citizens engage in weekly sport or exercise.
The number of continuously active sports practitioners has reached 17.4 million, and the sedentary population has shrunk by more than 2 million since 2019. Growth is particularly strong among children and those over 65, demographics that benefit most from sustained physical activity in terms of cognitive health, bone density, and metabolic control.
Minister Abodi emphasized the cultural shift: "Sport is school, it is social, it is increasingly about sustainability, and now it has a close relationship with health. Sport can be prevention and cure, and the prescribability of sports and motor activity as an engine of well-being is spreading more and more."
What This Means for Residents
For those living in Italy, the integration of sports into the health system creates tangible opportunities:
• Ask your GP about prescription exercise: If you have a chronic condition such as diabetes, hypertension, obesity, or COPD, you may be eligible for AFA or EFS programs at little or no cost.
• Check local availability: Regional health authorities (ASL) are publishing lists of accredited associations and calendars for AFA courses through 2025–2026. Search your local ASL website or inquire at your family doctor's office.
• New facilities coming online: If you live in a southern municipality, check whether your town is among the 85 recipients of "Sport Illumina" funding or beneficiaries of the "Sport e Periferie" grants. These spaces are designed for free or low-cost community access.
• Not yet tax-deductible: While AFA and EFS are medically prescribed, they do not currently qualify as deductible medical expenses for IRPEF purposes, despite a past tax credit.
Gaps and Challenges Ahead
Despite the progress, Italy still lags behind European benchmarks in the percentage of adults—and especially adolescents aged 11 to 15—meeting WHO-recommended activity levels. Territorial and socio-demographic disparities persist: access to sports facilities remains uneven, and sedentary rates are higher in economically disadvantaged areas.
The 2026 TEHA Sports Value Observatory Report noted that sport is not yet fully accessible to all Italians, and called for increased investment in prevention. Experts have recommended raising the National Health Fund's allocation to prevention to at least 6% within three years, aligning Italy with European norms.
A Prescription for the Future
The convergence of health policy, sports funding, and medical guidelines in Italy represents a pragmatic response to an aging population and rising chronic disease burden. With the sports sector now contributing 32 billion euros—equivalent to 1.5% of GDP—and employing 421,000 people, the economic case for prevention is no longer theoretical. The challenge now is ensuring equitable access to these programs and sustaining political will to fund prevention at European levels.
As Schillaci put it: "Today we have therapies, medical equipment, and the ability to treat diseases that until a few years ago were impossible to manage. But we must ensure that Italians don't get sick. And sport is fundamental."
