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The survey found 34% of Australian CEOs were very confident of growth over the next three years, compared to 46% globally.
The long-term outlook has also dropped sharply, from 48% last year to 34% this year, much lower than the 46% recorded globally and 51% recorded in the Asia Pacific.
"There is a lack of long-term vision for Australia, despite our solid economic position relative to other developed countries," PwC Australia CEO Luke Sayers said.
"When talking to our clients it is clear many Australian CEOs have a positive short-term outlook due to how well Australia weathered the global financial crisis but they are more subdued about the outlook for Australia's longer term future.
"This is because we still lack a clear understanding of how we are going to grow as a nation and compete globally."
In Australia, over-regulation, the government's response to debt and slow growth in developed countries were highlighted as the top three economic risks to growth.
CEOs said the top three business threats were availability of key skills, rising labour costs and high or volatile energy costs.
Sayers said many CEOs were focused on creating lean and efficient companies but this effort risked missing substantial growth opportunities.
He said action from political and business leaders was needed to help draw a long-term roadmap and reforms to tax and infrastructure would be critical.
"Like many Australian CEOs we believe the case for fundamental tax reform just keeps getting stronger to support growth in real incomes, increased productivity and workplace participation," he said.
Strengthening business and investment links with Asia was also flagged as a key focus.
The survey found CEOs in Australia were among the most concerned in the world that government should make infrastructure its number one priority.
Only CEOs in Africa and Romania ranked it higher.
Technology will be the biggest transforming trend for business, according to 91% of Australian leaders - far higher than the 80% recorded in the Asia Pacific and 81% globally.
