Italian President Carlo Azeglio Ciampi has called for the "cancer" of Mafia crime to be cut out of Italian life during a visit to the city of Naples.
Last year alone, 134 people - including many innocent bystanders and passers-by - were killed in a vicious war between rival factions of the local Mafia.
Mr Ciampi addressed a crowd in Scampia, a Naples suburb that has seen some particularly violent Mafia murders.
A Neapolitan crime bosses' turf war has continued despite a police crackdown.
There were three more killings in Naples over the New Year.
A police dragnet operation yielded more than 50 arrests last month.
Threat 'not diminished'
It is highly unusual for the Italian head of state - whose functions are mainly ceremonial - to penetrate into the heartland of organised crime.
" We must react and eradicate this cancer which is blighting our lives "
But President Ciampi, perhaps Italy's most respected elder statesman, insisted on spending some time in Scampia.
A small crowd of about 300 local residents applauded when he told them: "We must react and eradicate this cancer which is blighting our lives."
More than 100 of last year's Mafia-related murders were in connection with the struggle by various crime syndicates in Naples for control of the lucrative drug trade.
Meanwhile in Sicily, another part of Italy where the Mafia still reigns, Luca Tescaroli, a top judge whose life has been threatened, said organised crime remained alert and ready to strike anyone serving the Italian state.
Recent analyses concluding that the Mafia threat was diminishing were mistaken, he said.
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