From the BBC:
The government is to hold an emergency meeting to find a solution to the rubbish crisis. Naples dustmen stopped collecting rubbish two weeks ago. ... Finding a solution to this problem means tackling the mob. ... The Camorra, the Neapolitan version of the Mafia, has turned this into a hugely profitable business. ... They have sabotaged every effort to build hi-tech incinerators, so that Naples must rely on landfill sites, where they can hide the domestic and industrial waste, which they chuck in from all around the country. ... Millions of tonnes of it have been dumped illegally in the sea or in the countryside, untreated and highly toxic. ... Doctors say cancer rates in Naples are much higher than the national average.
1. Political system: Is it too fragmented i.e. is power too diffused for the central government to impose its will.
2. Democracy: Are elections and the high turnover in leadership a part of the problem?
3. Corruption: Is the mix between politics and business (e.g. Berlusconi and perhaps current elected representatives) too closely related (in comparison to say U.K or France or U.S.)?
4. Crime: Does the mix between politics and business invite criminal influence?
5. Industrialized country: Does Italy rank closer to EU average countries in terms of governance, corruption and GDP than it does to say Thailand/Kenya/India?
Here is one opinion by Alberto Alesina. I don't know if economic reforms can be undertaken first without considering the politics in Italy.