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Comparative analysis of the recent evolution of its economic, institutional and demographic structure leads to the conclusion that Italy has slumped almost to the bottom of the list of advanced countries, and can now be defined as a country in decline. The various aspects of this decline can be grouped together under five broad categories: the weakness of the conjunctural results of the economy in the course of the Nineties, the economic-political credibility gap (especially at an international level), the weakness of economic institutions in taking and implementing decisions, the culture lag (confirmed by a number of indicators) and the demographic crisis with birth and fertility rates among the lowest in the world. These weaknesses are set off by a great many promising signs of vitality, especially evident in the economic fabric, but these are not enough in themselves. Any strategy to make Italy survive in a global market economic system has to eliminate the structural weaknesses mentioned above. And action has to be taken immediately.