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Italy’s experience during COVID-19

Italy’s experience during COVID-19

Policy brief | Italy’s experience during COVID-19 and the limits of privatisation in healthcare


 GI-ESCR is publishing its brief on Italy’s experience during Covid-19 to show the desastrous consequences of healthcare privatisation in the country and call on all countries to review their approach to healthcare systems. The publication is based on the exemplary case of Lombardy, which quickly became the archetype of a failed response to the pandemic as a direct result of the high level of privatisation of healthcare.

The first outbreak of COVID-19 in Europe was detected in the Italian town of Codogno, Lombardy, on 21st February 2020. The region quickly became the archetype of a failed response to the pandemic. Infected patients overcrowded hospitals, multiplying the spread of the virus. The scenario resembled a conflict zone, with military trucks managing bodies and funerals without the bereaved. Frontline healthcare workers at public hospitals were left inadequately protected in war-like triages. Meanwhile, the regional government paid private care homes to host COVID-19 patients, spreading the virus amongst the vulnerable elderly.

By comparing and contrasting the case of Lombardy to the neighbouring region of Veneto, which registered the first cases in the same month but fared significantly better in terms of health outcomes, GI-ESCR explains its this brief how Lombardy’s poor health-policy response to the pandemic was likely due to its high level of healthcare privatisation.


  • Privatised and commercialised healthcare systems are less effective in responding to crises such as a pandemic, and could put at risk the health and lives of the population they serve. 

  • States must ensure that their healthcare systems are  built on a strong, quality, coherently regulated non-commercial sector. Any commercial private actor may only supplement and not supplant the public and non-commercial actors. 

  • Commercialisation of healthcare, as it happened in Lombardy, could constitute a violation of States’ human rights obligations enshrined in the Constitution and national law as well as in international human rights treaties ratified by the country.  

  • Human rights monitoring bodies, such as the United Nations human rights treaty bodies, should also play a more active role in assessing whether States’ health systems, including potential marketisation reforms, comply with their human rights obligations, in particular in the context of the pandemic. International development actors, including international and philanthropic organisations, should focus their efforts on supporting strong public healthcare and stop the promotion of market approaches. This will be particularly critical to respond to future crises that are likely emerge from the ecological breakdown. 

We discussed the findings of this report on the leading human rights blog Open Global Rights: you can read it in English and Spanish. We also made the headlines on the Italian newspaper Il Manifesto (online version of the op-ed here).

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The research on Italy was presented at the World Bank Civil Society Policy Forum (CSPF) Annual Meeting 2021 - October 6 2021: “Building back better healthcare systems – Lessons from the WBG’s COVID-19 response and recovery plans” . You can read the presentation below:

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