Chapter 2
Blossoming partnerships
for a future-proof Health & Care
Public-Private Partnerships (PPPs) are formalised national multi-annual, thematic and programmatic collaborations between quadruple helix organisations that contribute to the central and at least one of the four other Ministry of Health-missions for the societal theme Health & Care. PPPs include end users like professionals and/or citizens during their development and in their operations. Each of the 40 PPPs contributes to the Central Mission in its own unique way to ensure that in 2040 “five more years of healthy living and reducing socioeconomic health differences by 30%” is reached.
Most of these these strategic PPPs are supported by one or more KIC-partners, firstly via focussed information and sandpit sessions, secondly via matchmaking meetings to enable maximal knowledge exchange and collaboration between relevant public and private stakeholders and partners. Once the colleboration is set and the innovation-programme and instrumental technicalities are approved, Health~Holland, mostly in coalition with other financers, stimulates, facilitates and finances the PPP-programme. Most of the PPPs cover a specific area of a disease, such as cardiovascular diseases (DCVA) and Cancer (Oncode) or a more generic and overarching theme like regenerative medicine (RegMed XB) or the national infrastructures for health data (Health-RI).
Letter to parliament (15 October 2021)
‘In mission-oriented innovation, the emphasis is on more than technological development alone. It is about behaviour, regulation and affordability, with attention for the end user. Private organisations, scientists, the government and as many new challengers as possible work together in public-private consortia. Consortia that understand that innovation asks a lot of people, and therefore see that challenges should be approached from different angles. The approach that the Netherlands chooses is unique, but not straightforward, or easy.’
Innovating mental health
A large number of national public-private partnerships focus on areas of somatic diseases. In light of the Mission-Driven Top Sector and Innovation Policy, attention broadened since 2019 when attention was raized towards public-private R&D and innovation in the area of mental health. Brain and psychosocialal diseases must be tackled together with clients/patients, their relatives and loved ones, researchers, care professionals, knowledge institutes, companies, and societal and governmental organisations.
To this end, ZonMw, MIND and the Dutch Brain Foundation launched a large initiative called Hoofdzaken, which aims to mobilise 250 million euros in 10 years for research and innovation in brain related and mental health. To realise this, Hoofdzaken advocates for a national knowledge and innovation programme in which knowledge and data on psychiatry, psychology, neurology and neurosciences are brought together and better solutions for patients are implemented in practice faster.
We interviewed Prof. Dr. Robert Schoevers, Professor of Psychiatry and Head of Department Psychiatry of the University Medical Center Groningen, about what partnerships in the field of mental health can do with and for clients and patients, in the innovative ecosystem.
INTERVIEW
With Prof. Dr. Robert Schoevers
‘We do a lot of research into what cause mental disorder, how it then develops and whether we can find meaningful subtypes that would lead to better treatments. We are very interested in new ways of looking at psychopathology, and potential new interventions. We are looking at the full continuum. A lot of our clinical research focuses on the most persistent conditions and patients, whereas in research we also collaborate with many societal partners to work on better prevention. It is vital that we invest in reducing the prevalence of psychopathologic conditions at a population level. Right now, the numbers are staggering.’
Robert notes that, just as with many other conditions, for psychiatric disorders, the burden of disease is the highest for people with a lower socioeconomic status and people with a less healthy lifestyle, which often goes hand in hand. Furthermore, mood disorders, in particular depression, are twice as likely to be developed by women as men. Depression is one of the most prevalent disorders with an extremely high disease burden, especially for people with chronic depression who do not respond well to treatment. Chronic depression comprises about 80% of the disease burden for depression. ‘And that’s where you want to innovate’, says Robert.
A steady infrastructure
‘To innovate, you need research, and for research, you need a steady infrastructure of professionals and treatment facilities. In practice, it is difficult to set up an infrastructure and find funding for it as an individual researcher or organisation; a situation that many people will recognise.’ Robert says that working within a larger network provides four driving factors for innovation: 1) sharing knowledge with patients, society and professionals; 2) educating people on new interventions; 3) a collective data infrastructure that allows us to look at problems on an aggregated level between all parties involved; 4) shared financing that will also elicit more commitment from parties that are not used to working under these circumstances. ‘These factors are crucial for the field as they allow us to boost innovation. Everyone, industrial partners, clinical partners and patients, will benefit from these developments. For that reason, we hope that our current PPS proposal will be funded as a start of such a comprehensive collaboration.’
Catching up
Attention for psychological problems is growing and, in general, the stigma surrounding these is decreasing, especially when compared to the situation 30 years ago. The Netherlands has a large mental health sector, but if we look at the disease burden compared to expenditure per patient, we could argue that there is a big divide between somatic and mental health. ‘For some somatic disease areas, expenditures per patient can be a factor of 20 or 30 higher for research, compared to areas in mental health. ‘We have a lot of catching up to do’, says Robert.
The manifest Hoofdzaken is part of this “catching up” and aims to mobilise 250 million euros in 10 years for research and innovation in mental health. Hoofdzaken is a research agenda. However, Robert states that if the projects funded by Hoofdzaken can land in an infrastructure described like the one described above, they can significantly strengthen each other’s efforts.
Support Hoofdzaken and sign the manifest
With the support of all involved in the brain and psychological domain, we are stronger. Hoofdzaken is supported by over 140 professionals, experts by experience, organisations and initiatives. You can also show your support by signing the manifest here.
2021: Kick-off ABOARD and P4O2
We are very excited and proud to have celebrated the kick-off for two large strategic public-private partnerships this year. ABOARD and P4O2 both show the innovative capabilities of these long-term collaborations, and we are eager to see what their future has in store for the societal theme Health & Care.
ABOARD
ABOARD (A personalized medicine approach for Alzheimer’s disease) is a collaboration of more than thirty partners to stop Alzheimer’s disease. It contributes to the much-needed support that is crucial to achieve the Ministry of Health, Welfare and Sport’s Mission IV, which is centred around improving the quality of life for people with dementia. ABOARD aims to stop Alzheimer’s disease before it starts, which entails: improving diagnostics, developing tailored risk profiles, and focusing on prevention.
Wiesje van der Flier, project leader for ABOARD: ‘Research has shown that Alzheimer’s develops during a period of twenty to thirty years. That’s where the key is: intervening before symptoms arise. We have to reach people that are at risk of developing the disease, and that’s all of us. We also aim to take the necessary steps to make tailored treatment possible in the future. Sharing knowledge about improving brain health, and on how to support people with Alzheimer’s disease is also part of this project. A lot is still needed to prepare the Netherlands for a future with tailored treatment.’
P4O2
P4O2 (Precision Medicine for more Oxygen) aims to improve the quality of life for patients with chronic lung diseases like asthma, COPD and lung cancer. P4O2 will start a research programme to fundamentally improve the early detection, prevention, and treatment of lung disease. Coordinated by Amsterdam UMC, the P4O2 consortium has a budget of over 14.5 million euros and is co-funded by Top Sector Life Sciences & Health (Health~Holland). Approximately one in seven people develop lung disease, making it one of the leading causes of death worldwide (WHO).
Principal investigator professor Anke-Hilse Maitland – van der Zee of Amsterdam UMC states: ‘We still do not fully understand why certain people develop lung disease and others do not. When chronic lung disorders are diagnosed, people often have already accumulated so much damage and lost so much lung function that recovery is no longer possible. P4O2 aims to contribute to much earlier diagnosis, limiting lung damage and improving quality of life.’
