Camillo Ricordi: “Healthy longevity is the big challenge, and Italia has a head start”

Yet some countries seem to achieve better results with fewer resources. What does this comparison tell us?

When comparing per capita healthcare expenditure with healthy life years, a very clear picture emerges. The United States comes last. South Korea, Japan and Singapore lead the way. Italia is fourth and is the first Western country among the top five in the ranking, followed by China. The common feature of the most efficient systems is not that they spend more, but that they invest earlier: in nutrition, physical activity, lifestyle choices and the ability to identify risk factors before they develop into disease

In this context, what role can predictive diagnostics and artificial intelligence play?

Today, we can detect signs such as insulin resistance and low-grade chronic inflammation months or years before they develop into a disease. A collaboration between Milan and Miami has developed a test to identify dozens of hidden risk factors by using advanced technologies to analyse a single drop of blood collected via a finger-prick and sent on a postcard to the laboratory (BioReveal Healthspan Panel). Artificial intelligence now enables us to analyse vast amounts of data and transform them into individual health trajectories, helping to predict where a person is heading rather than merely describing their current condition. This means moving from a form of medicine that simply names diseases to one that seeks to anticipate them, either before the process has even begun (predictive diagnosis) or whilst it is still reversible (early diagnosis).

When you talk about prevention, you use a word that also features in economic terminology: investment. Why is that?

Because prevention is probably the investment with the highest return that a healthcare system can make. A study published in *Nature Aging* estimates that just one additional year of healthy life, across the entire population, could generate savings for the global economy of around 38 thousand billion dollars. This does not mean giving up on advanced treatments. On the contrary: the savings achieved through disease prevention would allow for greater investment in those who are already ill, including those with rare diseases, where ‘market-driven’ intensive care is often lacking. No one is left behind, but treatment becomes the last line of defence, not the first.

What is the message for a country like Italia?

Italia today presents an interesting case because it manages to translate relatively modest expenditure into good, healthy longevity. But this advantage is not guaranteed to last forever. We are already amongst the leading European countries for childhood obesity, and this is a major wake-up call if we wish to maintain this advantage or follow the same trajectory observed in the United States. The tools already exist: predictive diagnostics, artificial intelligence, prevention and policies that reward people’s health, the food they consume and the environment around them (One Health), rather than merely treating disease. The question is not whether we can afford this change. It is whether we can afford to put it off.