Foresight and scenarios to make more sustainable and effective decisions

Thinking about the future again to govern the present

When did we stop thinking seriously about the future?

It is a question worth asking in an age dominated by urgency. Over the past decade, economic crises, public health emergencies, geopolitical tensions, technological acceleration and climate change have forced governments, businesses and institutions into a permanent state of reaction. Politics and economics alike have become increasingly focused on managing the immediate, replacing the capacity to anticipate with the necessity of keeping up.

Yet the more uncertain the world becomes, the greater the need for long-term thinking.

As we explain in this short guide, this is the challenge behind the Future Briefs launched by Ecosistema Futuro. Rather than engaging in speculative predictions, the goal is to bring a still underused practice into the public debate: foresight, the systematic exploration of alternative possible futures in order to improve decisions.

The future is often invoked as a slogan. It appears in political programmes, corporate strategies and institutional documents. Far less often is it examined with tools capable of addressing its complexity. Understanding the future does not mean predicting it. It means identifying the transformations already under way, analysing how they interact and developing alternative scenarios that help us assess the opportunities, risks and consequences of present-day choices.

This approach is established in some countries, yet it remains relatively marginal in Italy. And yet contemporary challenges increasingly expose the limits of emergency-driven and fragmented thinking. Major transformations do not unfold in isolation. Population ageing affects labour markets and welfare systems; technological innovation reshapes economies and education; climate change influences infrastructure, public health and competitiveness. Treating each of these developments separately often leads to incomplete responses to problems that are fundamentally systemic.

The ambition of the Future Briefs is straightforward: to provide public and private decision-makers with tools that expand the time horizon of decision-making. Not ready-made or prescriptive solutions, but interpretative maps for navigating a world of growing complexity.

The first Future Brief: healthcare professions in Italy

The first brief in the series, dedicated to the future of healthcare professions in Italy and produced by Randstad Research, offers a particularly revealing example of this approach. Healthcare is one of the sectors where decisions taken today will have profound consequences for society over the coming decades.

Population ageing, workforce shortages, digital technologies and artificial intelligence are already reshaping Italy's National Health Service. The evidence points to mounting structural pressures. Public healthcare spending remains below the European average as a share of GDP, while the country faces a significant shortage of doctors (25,000) and nurses (250,000). Recruitment difficulties are compounded by the ageing of healthcare professionals themselves, even as demand for care rises alongside an older population.

Faced with these trends, simply describing what is happening is no longer enough. The more important question is how these dynamics might interact and what different outcomes they could produce.

For this reason, the report develops four scenarios for 2032, which I encourage readers to explore. The first imagines a highly digitalised healthcare system. The second centres on the needs of an ageing society. The third projects a future largely characterised by continuity, where current weaknesses remain unresolved. The fourth outlines a desirable future, combining the strengths of the other scenarios: investment in technology, stronger community-based healthcare, greater investment in human capital, reduced regional inequalities and the adoption of a One Health approach linking human, environmental and social wellbeing.

Possible futures, desirable futures

The simple question of what the future will look like is not enough. We must ask ourselves what the future we consider desirable is.

Thinking about the future inevitably involves a normative dimension. It is not enough to ask what might happen. We must also ask what kind of future we would like to build. What balance should exist between innovation and fairness? Which priorities should guide our choices: sustainability, economic growth, social cohesion, quality of life?

From this perspective, speaking about "futures" in the plural is not merely a methodological choice. It is also a democratic one. It acknowledges that the future is not predetermined and that collective decisions, developed through debate and participation, can influence its direction. It rejects both the fatalism that treats certain outcomes as inevitable and the illusion that every development can be accurately predicted.

Ecosistema Futuro draws inspiration from the Pact for the Future, the United Nations Sustainable Development Goals and the principle, introduced into the Italian Constitution in 2022, that the interests of future generations deserve explicit protection.

No foresight exercise can eliminate uncertainty. On the contrary, its purpose is to embrace it and make it visible. Recent history has demonstrated how improbable but high-impact events, from pandemics and geopolitical conflicts to financial crises and disruptive innovations, can rapidly alter trajectories that once seemed firmly established.

Building a culture of anticipation does not mean claiming to know what tomorrow will bring. It means developing the capacity to prepare for different possibilities, recognising that the future is not simply something that happens to us. It is also something shaped by the decisions we make today.

Italy is often criticised for its inability to look beyond the short term. Our hope is that projects such as the Future Briefs can help change that, by encouraging better questions and promoting informed conversations.

In an era of permanent uncertainty, the quality of our questions may well be the first condition for the quality of our decisions.

The "Guide to the Future Briefs series" and Future Brief No. 1, "The Future of Healthcare Professions in Italy," produced by Randstad Research, are available online.

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