Belgium

As a neighbouring country, Belgium is a major trading partner of the Netherlands: around 10% of total Dutch exports go to Belgium. In the Life Sciences and Health (LSH) sector, Belgium is a convenient trading partner close to the Netherlands. In recent years, many activities have been organised to strengthen the relationship between the LSH sectors in both countries. Future activities will be aimed at further strengthening this relationship to facilitate multi-annual programming.

Belgium operates an advanced health system. Federal authorities and federated entities have different responsibilities. Federal authorities are responsible for regulating compulsory health insurance, the outpatient budget, hospital budget and programming standards, pharmaceuticals, their price control, and healthcare professions. The federated entities (regions and communities) are responsible for health promotion and disease prevention, the organisation of primary and palliative care, maternity and child healthcare, social services and community care, the financing of investments in hospitals (infrastructure and heavy medical equipment) and the determination of hospital licencing standards. Interministerial conferences are regularly organised to facilitate cooperation between the federal authorities, the regions and the communities.

However, several health challenges are forcing the Belgium health system to adapt and improve. Major challenges include the consequences of an ageing society, chronic diseases and the resulting shift in healthcare demand. In recent years, Belgian health policy has focused on making health services more efficient. In the coming years, the Belgium government will focus on rationalising healthcare services by merging hospitals and health workforce planning (TFHC Market Overview 2018).

example

Trade

Ageing society
Comparable to many West European countries, Belgium faces the consequences of an ageing population. In the coming 10-20 years, a significant proportion of the population will reach pensionable age. This will lead to increased demand for elderly care and assisted living facilities, while there is also a rise in chronic (non-communicable) diseases. Already 23% of total healthcare spending is on long-term care. To keep up with this development, the Belgium government is expanding capacity for eight thousand assisted living facilities for vulnerable groups in society.

Prevention
Besides an ageing population, the prevalence of inactive and unhealthy lifestyles is rising, resulting in chronic diseases. Belgium is seeking solutions that help prevent chronic diseases and help to maintain good health. Currently, only 2% of the total healthcare budget is spent on prevention, but it is expected that this will rise. Strengthening primary care and improving care coordination is part of this effort. To support this, a national ‘integrated care for better health’ plan was approved on federal level in 2015. In line with prevention, there is also more focus on mental health.

Digital transformation of healthcare
Building on a previous eHealth plan from 2013-2018, Belgium has adopted a new action plan eHealth plan for 2019-2021. This plan has and will facilitate the development and introduction of digital tools for patients and care providers. Sharing and digitalising information, between - and in - primary care and hospitals is a crucial part of this plan. The adoption of electronic medical records and e-prescriptions has risen tremendously, while a new secure online platform is also being developed.

Innovate

Pharmaceutical industry
An above average number of drugs are being developed in Belgium, while the country also has prominent production and manufacturing capacity. This offers major potential for R&D partnerships with the Belgian private sector and research institutes (TFHC Market Overview 2018). Also, clinical trial speed and number of applications are among the highest in Europe.

Personalised health & personalised medicine
In 2018, the Flanders Department of Economy, Science and Innovation and the Dutch Ministry of Economic Affairs & Climate Policy signed a MoU on enhanced cooperation in the field of personalised medicine. Four subthemes are addressed: Regenerative Medicine, Cell-based technologies amongst others Organ-on-Chip, Prevention and Lifestyle medicine, and Personal data infrastructure and management. A bilateral R&D call between EWI/VLAIO and EZK/H~H/RVO is in the making for which matchmaking and expert round tables are foreseen. In addition to this, further thoughts on a concrete programme of cooperation are being discussed.

Invest

Belgium is not a priority country for foreign direct investments, but we do see an increase in interesting projects. For this reason, we will follow the trade and innovation activities and decide every year if we will put more effort for active acquisition in Belgium. At this moment we are open to work on projects from Belgium that are in line with the Invest in Holland strategy 2020-2025.

Regional priorities

Brussels
Brussels is an important region because of the presence of the national government, ministries and innovation hubs. This makes the region unique compared to Flanders and Wallonia.

Flanders
The Flanders region has been a natural trading partner for Dutch organisations, since they share a border and a language. In 2015, the Flanders region started a reform trajectory for their primary care system. This was aimed at more person-centred integrated care. Other initiatives consider regulations for the delivery of primary care, home care and elderly care.

Wallonia
Wallonia has comparable attention for better integration of care. However, priority is given to promote access to care, which is supported by sending doctors to underserved areas1. Compared to Flanders, the biopharmaceutical industry and MedTech are key areas due to the presence of major companies in these fields.

Overview of Dutch interest in Belgium per organisation type:

  • Based on Achilles data, Belgium took up 1% of all incoming trade questions in 2018- 2019.
    • Mission 2018 - 37 participants
      32 private companies (SMEs, large firms)
      2 health clusters
      3 knowledge institutes
    • Mission 201 - 23 participants
      23 private companies (SMEs, large firms)

Most prominent NL value chains

  1.  Value chain Healthy Living & Ageing ‘Research and solutions that contribute to maintaining (prevention), strengthening and recovering (rehabilitation) physical and mental wellbeing, by increasing people’s independency.’
    Life expectancy in the Netherlands is one of the highest in the world and the Dutch therefore have considerable experience regarding healthy living and ageing. They know that a holistic approach and multidisciplinary collaboration are key pillars in achieving healthy living. They also acknowledge the important role of prevention and healthy lifestyles.
    The Belgium elderly population demands both an expansion of existing (geriatric) healthcare services and adapting current health delivery models. In addition, there is a need in Belgium to accelerate the plans regarding prevention. By means of primary care and care coordination (integrated care), Belgium strives to keep patients out of expensive hospitals. By making care more integrated and focused on home care, healthcare will become more efficient and patient-centred.
     
  2. Value chain Connected Care: ‘connecting data, systems, information and persons in a convenient, safe and secure way’.
    Dutch expertise in Connected Care facilitates anytime and anywhere access to healthcare. This makes healthcare available to everyone regardless of their socioeconomic background. Dutch eHealth solutions are renowned for their simplicity, consistency and flexibility. They are being developed through extensive collaboration and co-creation, involving government, research institutes, SMEs, multinationals and civil society. The small Dutch home market forces them to adapt solutions to international standards, cultures and ways of working.
    Sharing and digitalising information is crucial for facilitating the eHealth plan 2019- 2021 from the Belgian government. With the rise of home care, there is an increasing need for enabling technologies in this field. These enabling technologies are necessary to assist the value chain of Healthy Living & Ageing.
     
  3. Value Chain Digital Health ‘the use of data for clinical decision-making, diagnosis of disease, detection of acute and long-term risks, treatment plans and monitoring’ Dutch research is focused around health data management and detection & screening tools, which can facilitate data analysis. Dutch solutions have a strong focus on improving efficiency and clinical decision support tools.
    Since more and more health-related data is being measured and collected in Belgium, the potential for analysing this data is increasing. Dutch organisations can support the transition of Belgian healthcare towards digitalisation. The Netherlands has considerable experience in digital healthcare, which it is ready to share with similar countries like Belgium.
     
  4. Biopharmaceutical Developments/Personalised Medicine
    Considering the strengths of the Flanders and the Netherlands biotech ecosystems and joint ambitions in the field of personalised medicine, Biopharmaceutical Developments and Personalised Medicine is the fourth value chain on which sustainable bilateral cooperation is foreseen.

Overview milestones & flagships

  • G2G (MoU, state visits, thematic focus on prevention and digitalisation, for example)
  • Trade (PIBs, Market study, missions, incoming delegations)
  • Innovate (joint R&D projects, specific bilateral calls)
  • Invest (significant investments in the Dutch LSH sector)
  • RegMedXB is a longer running, cross-border, strategic collaborative effort between Dutch clusters and the Leuven region

2018

  • Economic mission to Belgium (Leuven). Led by Sigrid Kaag, Minister for Foreign Trade and Development Cooperation. Focus on digital health.​​​​​
  • Signing of MoU Netherlands & Flanders on Personalised Medicine

2019

  • Healthcare mission to Belgium
  • Thematic focus on eHealth with emphasis on elderly care.
  • Incoming Belgian mission to the Netherlands as part of the Health~Holland Visitors Programme (HVP) and World of Healthcare.

2020

  • Incoming Belgian mission to the Netherlands as part of the Health~Holland Visitors Programme (HVP) and World of Healthcare.

2021

  • Life-on-Chip Conference 2021
  • Knowledge seminar
  • Health~Holland meet-up Belgium, to update LSH organisations on the latest developments in the Belgian healthcare market.

The way forward

Several initiatives will be deployed from 2021 onwards to strengthen relations that have been built up in recent years:

  • Facilitate matchmaking & getting in touch with key stakeholders COVID-19 has made it harder to get in contact with potential business partners, stakeholders and decision-makers. However, the need to do so still exists and will be facilitated through (digital) missions, which include dedicated matchmaking.
     
  • Knowledge sharing
    Dutch and Belgian LSH organisations have considerable experience, which can benefit the internationalisation of other organisations. Efforts to facilitating knowledge sharing among stakeholders will therefore be stimulated.
     
  • Bilateral R&D cooperation
    Within existing frameworks for bilateral research and innovation cooperation, like EUREKA, Eurostars and Horizon Europe many Belgian-Dutch collaborations have been supported over the years. These programmes and associated matchmaking and networking events can be used to strengthen the bilateral ambitions.
     
  • Building sustainable relationships with Belgian counterparts
    Building long-lasting relationships is an integral part of the Health~Holland International Strategy 2020-2023. It is a requirement for the intended multi-annual programming in Belgium. Relationships built up in recent years will be strengthened. Intended broader collaborations are foreseen with In4Care, Agoria and Voka Health Community as well specific collaborations with EWI, VLAIO and FWO in line with the MoU. A bilateral R&D call between EWI/Vlaio and EZK/H~H/RVO is in the making for which matchmaking and expert round tables are foreseen. In addition to this, further thoughts on a concrete programme of cooperation are being discussed.

(Preferred) actions

  • Collective participation (mission or NL pavilion) at Health & Care 2022.
  • Matchmaking and further deepening of collaboration on personalised health concerning the MoU with Flanders. A bilateral R&D call is in the making and further thoughts on concrete programme of cooperation are being discussed.
  • Collaboration between Voka, Agoria, In4Care and TFHC to further connect the healthcare ecosystems.
  • Follow-up on activities Artificial Intelligence and Health.