Colombia is Latin America’s fastest growing and most stable economy; COVID has had a huge impact, but not as much as on other countries in the region. The Colombian health system has been named the best in Latin America and is ranked 22 worldwide by the WHO.
Colombia is a country of contrasts, while in the largest cities one can receive a very high standard care, in rural and remote areas the provision of quality healthcare is lagging. The country is working on strategies to close the gap, facing challenges such as efficiency, financial sustainability, and addressing those factors that cause pressure within the system. The impact of an ageing society and the subsequent increase in non-communicable diseases are examples of some of the pressures. Since the Netherlands has a comparable health system to Colombia, Colombian healthcare stakeholders are eager to interact with the Dutch, with many of them looking to the Netherlands as one of the top reference countries. This combination leads to opportunities to provide highly innovative healthcare solutions, which has resulted in the establishment of the Partners for International Business (PIB) WeCareColombia developing initiatives that contribute to improved public health.
The most recent and important developments in Colombia’s healthcare sector include the reformulation of the Ten Year Health Plan, the submission of a Health Reform and the increased attention for financial sustainability.
The priorities of the health sector and the dynamics of public health in Colombia are guided by the Ten Year Health Plan. The Ten Year Public Health Plan is a public policy that includes the roadmap that establishes the objectives, goals and strategies to face the challenges for communicable and non-communicable diseases for public health in the next 10 years. Currently, the National Government is designing and formulating the next Ten Year Public Health Plan, which will be presented in May 2022 and will be valid until 2031. According to the Ministry of Health, the priority topics to be highlighted are: dispersed territories, remote areas, and pharmaceutical security.
In the last semester of 2020, Congress representatives submitted a Health Reform to manage the country’s health systems’ limitations that were exposed during the pandemic. Due to the strikes and protests that occurred in early 2021, Congress withdrew the project because of popular opposition. However, the bill left the discussions of changes to Colombia's healthcare system on the agenda. The perspectives that gained strength in the discussion are the necessity to further discuss health outcomes, the unification of the contributory and subsidized regimes, and the management of health from a territorial perspective.
Within this Health Reform, the Colombian government is discussing different measures to reduce the burden of healthcare spending. The measures are focusing on the unification of health financing through the UPC and the Maximum Budgets, a measure introduced in 2020 to control spending on high-cost treatments. In addition, the Ministry is currently developing guidelines for mechanisms such as managed entry agreements. These discussions have further boosted discussions on cost-effectiveness and therapeutic value assessments of health technologies.
Considering its contrasts, Colombia welcomes highly innovative solutions and the development of projects that could address the main challenges within the health system.
From the perspective of the Netherlands the following market trends are of interest:
Colombia’s major investments in its healthsector provide numerous opportunities for the Dutch LSH-sector. Prominent investment schemes include the End-Point Agreement (to provide liquidy within the system) and the National Rural Health Plan (PSNR) aiming to improve sustainability and quality of health services and aiming to close the gaps between urban and rural areas.
These investments and developments may result in an increase in the purchasing of innovate medical solutions in the public sector in the coming years:
1. Public Health: The Ministry of Health has prioritized non-communicable diseases, human talent and increasing quality, therapeutic values and cost effectiveness as key issues for the coming years. Colombia is looking abroad for solutions related to prevention, screening, treatment, remote training and education.
2. Digital transformation of the health system: The use of digital solutions, such as telemedicine, e-health, big data, electronic health records and value based health care, are becoming more prevalent in Colombia. Two main trends can be distinguished: 1) the use of technology to provide remote care, 2) the unification of data systems for the effective use of available data to provide ‘outcome based care’.
3. Ageing Society: Colombia’s population has been steadily ageing for several decades. The % of Colombians over 60 will rise to 20.9% by 2050. Currently, home care, day care and residential care are fragmented and there is room for development. The National Government has set priorities including strengthening the quality of life and improving health status in the course of life, especially at high age and increasing quality and infrastructure of care provision to the elderly. Colombia seeks knowledge from experienced countries in terms of policy-making and different forms of care provision in order to deal with the challenges of a rapidly aging population.
Research & Innovation
Currently R&D collaborations between the Netherlands and Colombia have yet to be identified. Nevertheless, the 2020 emergency has led to add on top of the Colombian agenda: pharmaceutical security, advance therapies (drugs and medical devides) and bio products, which could offer opportunities for collaboration.
• The sustained growth of the Colombian pharmaceutical industry with a CAGR of 7% in local currency potentially offers opportunities for R&D collaboration.
Since the Netherlands Foreign Investment Agency (NFIA/Invest in Holland) doesn’t have a local office in Colombia, they do not have a proactive focus in Colombia. Reactively, NFIA/Invest in Holland is open to inform and assist Life Sciences and health companies that show interest in expanding in the Netherlands. They will focus on supporting companies that will contribute to the societal challenges and solutions of the future and strengthen the Life Sciences & Health ecosystem in the Netherlands.
20% of the healthcare system affiliates are located in Bogotá-region, followed by the states of Antioquia with 13% and Valle with 9%. Bogotá represents 75% of the sales of medical devices. Also, the quality of the institutions in Bogotá stands out, 8 of the top 63 hospitals in Latin America are located in the city, according to America Economia ́s 2020 ranking. Colombia is well positioned in this list as well with 26 institutions overall, as a matter of fact Colombia is the reference country to provide complex treatments to patients from the Caribbean parts of the Kingdom.
The Pharmaceutical market also concentrates in Bogotá, where 66% of the manufacturers and 65% of the wholesalers are located representing 49% of the sector ́s jobs. In addition, it is the main commercial hub of the industry with 47% of the exports and 82% of the imports. Urban centers such as Medellín, Barraquilla, Cali and Bucaramanga have a similar healthcare landscape as Bogotá.
Health services in rural areas in Colombia are developing fast as the Colombian Government designed the National Rural Health Plan (PSNR) after signing the Peace Treaty with the FARC in 2016. The PNSR stretches over 15 years and is financed by both the Colombian government and foreign donors.
As central agenda topic in the formulation of the new public health plan is meeting the needs of the population based on a territorial component and the territorialization of health.
Overview milesones & flagships
- G2G (MoU, state visit)
- Trade (PIBs, Market studies)
Collective Activities to Colombia 2015 – 2021
- Visit Minister of Health Schippers: Signing of the Work Plan for the Complementary Health Cooperation Agreement inititated in 2006.
- Holland Pavilion on trade fair Meditech in Bogotá – 16 Dutch companies & organisations, of which 60% still active (through distributors or projects) in Colombia.
- RVO TFHC Market survey LSH Colombia.
- Life Sciences & Health Roadshow through Colombia (Bogotá, Medellín, Bucaramanga, 10 participants), of which the NL Works pilot project with “Healthy Villages” is a direct result, as well as the telemedicine projects of Spectator and pneumatic tube system projects in hospitals of Telecom Tube Systems.
- Economic mission led by PM Rutte and SG Gerritsen (Bogotá & Calí) with 26 Dutch LSH companies.
- Signing Renewed Work Plan by Dutch & Colombian Ministries of Health.
- RVO TFHC Market Study LSH Colombia.
- Oncology and Palliative Care Missions.
- “Healthy Villages” pilot in the remote area of Guainía.
- Outgoing digital showcase as replacement of the physical expo and visit of the OES (Organización para la Excelencia de la Salud) International Forum in Cartagena that was scheduled for May 2020.
- Incoming mission Elderly Care Compensar.
- PIB WeCareColombia has been signed in May 2021. This public-private partnership aims to improve the structural collaboration working towards integrated healthcare in Colombia.
- Knowledge exchange Human Talent – Nurses.
- Knowledge exchange Oncology.
- Alliance between Holland House Colombia and Compensar (HMO).
The way forward
When it comes to the future LSH collaboration between the Netherlands and Colombia the ambition has been set to maintain and further grow the role of the Netherlands as one of the top reference countries to Colombia and grow the already sizable number of concrete collaborations. To proceed we suggest performing actions on a number of high-potential themes:
- Build-on long-term collaborations: The Colombian and Dutch Ministries of Health signed a Renewed Work Plan for the Complementary Health Cooperation Agreement in 2018, spurring collaborations in healthcare. As a consequence of the pandemic, cooperation and communication slowed down. The Netherlands is working on reestablishing and intensifying collaborations in healthcare through the PIB activities.
- Position the Netherlands in Colombia: The Netherlands LSH sector is positioned as a key partner in those areas of interest for both countries, via initiatives such as the Healthy Villages Consortium and the PIB cluster WeCareColombia for joint brand positioning.
- Explore and grow collaborations: There are great challenges within the Colombian health system to respond to the emerging needs in cancer and palliative care. The challenge for the country is focus on integral attention and quality. The concentration of services is within the main cities with great needs within the territories.
- Market information: Improve understanding and keep the Dutch LSH sector updated on developments in the Colombian health system through G2G via the PIB WeCareColombia, by organizing webinars and specific thematic seminars.
- Collective activities: Maintain relations with the Colombian health sector through the Health~Holland Visitors Programme, incoming and outgoing missions, thematic dialogues and webinars.