Strengthening Multilevel Public Health Governance: Lessons and Priorities from Italy’s National Prevention Plan 2026–2031

Italy renews its National Prevention Plan (NPP) on a multi-year cycle that binds all Regions to shared, centrally defined public health objectives. In 2026, the Ministry of Health adopted the NPP 2026–2031, which succeeds the 2020–2025 cycle and will guide regional prevention planning until 2031. The objectives of this opinion are to appraise the achievements and principal shortcomings of the outgoing cycle, to analyse the innovations of the new Plan, and to propose priorities for its implementation. The main innovations of the new Plan include seven macro-objectives, fourteen binding thematic areas, a reinforced multilevel governance architecture, an NRRP-funded National Health Prevention Hub for intersectoral data integration, and a national digital platform for planning, monitoring, and evaluating Regional Prevention Plans. Drawing a comparison between the Italian model and comparable approaches adopted elsewhere in Europe, the paper situates the NPP 2026–2031 among Europe’s statutory, cascading prevention frameworks. Converting adopted policy into equitable, sustained population health gains will depend on proportional and durable funding, standardized outcome monitoring, and investments in adequate standard staffing levels for a multiprofessional public health workforce that operationalizes prevention at the local level.