In the upcoming local elections in Italy, Prime Minister Silvio Berlusconi faces the risk of losing his stronghold in Milan to the left for the first time in twenty years. The fragile state of his centre-right coalition has been highlighted by these elections, with the focus on key battlegrounds in Milan and Naples. Results are expected in the evening after voting began on Monday morning. The government is under pressure to cut the budget deficit by 40 billion euros following a downgrade in Italy's credit rating. A defeat in Milan would be a significant setback for Berlusconi, who is already dealing with various challenges including sex scandals, corruption trials, and a slow economy. Italy has a high public debt, but it has not faced the financial market troubles that Greece and Portugal have. However, a recent warning from S&P serves as a reminder of the consequences of not taking action. The current government's ability to handle the situation is being questioned by the business daily Il Sole 24 Ore. Berlusconi's party did not perform well in recent elections, with the center left holding onto power in Turin and Bologna, and forcing run-offs in Naples and Milan for the center right. A defeat would likely worsen a divide with his key ally, the Northern League, and may lead to challenges to his strong leadership of the center right, even though senior ministers have stated there will be no changes before the next national elections in 2013. Defence Minister Ignazio La Russa, a loyal supporter of Berlusconi, stated that he does not see any chance of an alternative government and believes early elections are not desired by anyone. In Milan, where Berlusconi started his political career, incumbent center-right mayor Letizia Moratti is behind in the first-round vote against leftist Giuliano Pisapia. Residents of Milan noted a changing atmosphere in the city after voting. Issues at the regional level, such as transportation and the ongoing garbage crisis in Naples, have influenced voters' decisions. However, the struggling national economy has been the main focus during the elections. Italy has been experiencing slow economic growth for more than a decade, with high youth unemployment and a decrease in the average Italian's wealth compared to 10 years ago. Berlusconi's government recently had to revise its growth forecast for the year downwards, as well as for the following year. Despite concerns raised by S&P about Italy's debt and growth, the Treasury was able to sell bonds successfully. Berlusconi, who initially underestimated the significance of the elections, has shifted his focus to attacking his political opponents on television. He predicted that if the left wins, Milan will turn into an "Islamic gypsyland". He also stated that leftist voters lacked intelligence, leading to Internet spoofs and a lawsuit from an offended voter. A rant against Italian magistrates directed at US President Barack Obama during the Group of Eight summit in Deauville, France caused Economy Undersecretary Daniela Melchiorre, a former magistrate, to resign in protest.