Healthcare systems at a crossroads: how to navigate pressure and opportunity 

Chronic diseases remain Europe’s main burden 

The opening keynote at the 2026 Vlerick Healthcare Conference was delivered by Ewout van Ginneken, Director of the European Observatory on Health Systems and Policies. Through the lenses of the upcoming 2025 Country Health Profile for Belgium, he offered an overview of Belgium’s performance compared to other European countries. Belgium has a relatively high life expectancy, yet the EU still shows an 8‑year gap between the best‑ and worst‑performing countries. Chronic diseases remain Europe’s main burden: cardiovascular diseases and cancers account for 55 % of all EU deaths. The report emphasises how 1.1 million premature deaths in the EU each year could be avoided with more effective prevention and robust public health systems. In this context, Belgium presents structural imbalances in the spending system compared with countries of similar profile: higher than average spending for inpatient, outpatient and long‑term care, but lower than average spending in prevention and pharmaceuticals, with an overall high share of private spending. This difference appears even more crucial if compared with demographic and epidemiological trends. 

Belgium has a clear role as a European life sciences hub, with five times higher pharmaceutical R&D investment per capita and twice as many clinical trials. Building on these strengths while addressing the current imbalances of the system will translate this potential into long-term health benefits. 

Five bottlenecks of the Belgian healthcare system 

The second keynote, delivered by Margot Cloet, CEO of Zorgnet‑Icuro, highlighted the high fragmentation of the Belgian governance model: six health ministers oversee a population of just 11 million. This complex structure produces well-recognised challenges across the sector, particularly by hindering continuity of care. Cloet identified five key structural bottlenecks that currently constrain the efficiency of the Belgian healthcare system: 

1. Exclusive competences that are not truly exclusive 
2. Fragmented powers disrupting continuity of care 
3. Ambiguous jurisdictional concepts leading to inefficiency 
4. Financing structures that cannot keep pace with demand 
5. Lack of shared administrative tools and consultation mechanisms 

Another element that Margot Cloet addressed in her keynote was the inadequacy of the current financing system to appropriately respond to the growing needs, resulting in 20% of the total healthcare budget being directly funded by patients. How can equity be guaranteed in this context? The Bismarck model – the foundation of the Belgian healthcare system – was originally built upon solidarity. The unclear policy-level directions are hampering it. 

After these two keynotes, the conference programme took a deep dive into three topic-specific sessions. 

Session one: Prevention 

Dr Emanuel Van Hoecke presented the Zeno2 project, an effort towards innovating prevention practices. The project is grounded in the fundamental concept that the most health benefits from prevention can be achieved by investing less, but earlier in life. And the more upstream the investment, the easier it is to address the social determinants of health.  

The objective is therefore to address the three pillars of upstream preventive care: 

1. A holistic approach, requiring collaboration across medical and social sectors 
2. Transmural and upstream thinking, replacing the traditional referral system with integrated cooperation 
3. Preventive medicine, focused on key burden drivers: sarcopenia, obesity, diabetes, dementia, and microbiome health 

Dr Katrien de Vusser addressed two reasons why we don’t think enough of prevention. Preventive thinking is currently hindered by cognitive biases, particularly the reactivity of modern medicine, with a scheme of problem, diagnosis and treatment. Secondly, there’s the mistaken assumption that life span equals health span, whereas many Belgians spend around 20 years in poorer health after age 60. The crucial part of longevity medicine is to align health span with life span, and we can do that through emerging biomarkers and hallmarks of ageing. These enable us to measure ageing, shifting prevention into a more precise, personalised discipline. 

Session two: Access to innovation 

1/ Reinventing intradermal vaccination by Ideavax 

Intradermal vaccines require only one‑fifth of the dose of intramuscular injections, making them an attractive solution in contexts of shortages or low immune response. But traditional methods of administration (e.g., Mantoux) are complex and painful. 

Vanessa Vankerckhoven and Koen Beyers presented how Ideavax developed VaxID, a device allowing perpendicular, painless, precise intradermal delivery. Their work included detailed studies of average skin thickness, enabling calibration of the device with greater precision. These insights informed the engineering of each component, ultimately leading to several component‑level patents that protect the unique mechanisms enabling consistent, painless intradermal delivery. 

2/ New drug modalities and patient‑centric delivery by Lonza 

As “easy” molecules are gone, pharmaceuticals focus on complex, fragile molecules with limited oral bioavailability. With 63 % of people afraid of needles and 15 % non‑adherent to their treatment because of injections, alternative administration routes are a priority. 

Giuseppe Pacileo explained how Lonza’s research focuses on: 

• Capsule formulations engineered to dissolve at precise gastrointestinal locations 
• Collaborations with pharma companies to preload advanced molecules in capsules 
• Strategies to overcome bioavailability limits of emerging treatment types 

Session three: Integrated care  

The two examples of antenatal care and haemophilia illustrated how fragmented processes create real-world barriers. For antenatal care, Dr Katrien Beeckman described the creation of a platform connecting the hospital to other stakeholders, along with the juridical and practical challenges this entails. 

Through the haemophilia case, Hans Constandt guided us through the fragmentation and compartmentalisation of data and the necessary steps for creating a digital platform. Once again, the limitation lies in the need for manual data entry, as integration of health records is still very low, preventing the diffusion of innovative solutions too.  

The keys to a sustainable Belgian health system 

The closing keynote by Lieven Annemans offered an outlook on the healthcare systems. Three guiding principles must be steering health policy: high-quality care, universal coverage, and financial sustainability. The Belgian system suffers from greatly fragmented care, with inappropriate and overuse of services and underuse of other valuable aspects of care. The first key to a sustainable health system is to empower patients in promotion and prevention activities, and to intervene on the social determinants of health and health literacy. Looking forward, care must be integrated, effective, and respectful of the capacity and well-being of the professionals involved.  

Belgium has a high‑performing healthcare system, yet its current structure is no longer sustainable. To stay resilient, the system needs to shift its focus toward prevention, integrated care, effective governance, and innovation that genuinely reflects patient needs. The 2026 Vlerick Healthcare Conference highlighted that workable solutions already exist and that many Belgian organisations are demonstrating promising leadership. Still, meaningful progress will depend on political bravery, better-aligned incentives, modernised infrastructure, and a collective societal effort to prioritise creating health rather than simply treating illness.