Perhaps to the surprise of many, Belgium is the world’s second-largest producer of vaccines, behind only the US, and – capitalising on its years of experience in the field – played a vital role in the development, production, and distribution of COVID-19 vaccines over the past three years. An ecosystem of start-ups and service providers has emerged around the multinational companies that have consistently invested in Belgian vaccines over recent decades, but there is still work to do to bring the country’s domestic vaccination programs in line with its world leading R&D and manufacturing capabilities.
COVID-19: A Call to Arms
The rapid development, regulatory approval, and distribution of effective vaccines against COVID-19 stands as one of the life sciences industry’s proudest moments in living memory. It allowed countries across the world to safeguard their populations from serious illness and eventually ease the stringent lockdowns and restrictions on personal freedoms that the pandemic precipitated.
As Caroline Ven of innovative industry association pharma.be elucidates, “our members were at the forefront of the production and distribution of COVID vaccines to the rest of the world.” The most notable example of how Belgium leveraged its long history in vaccine development and production was at Pfizer’s Puurs manufacturing site. Located strategically between Brussels Airport and the Port of Antwerp and operational since 1963, Puurs produces more than 400 million doses of injectable vaccines and medicines in various formats every year for export to over 170 countries.
Our members were at the forefront of the production and distribution of COVID vaccines to the rest of the world
Caroline Ven, pharma.be
The site was chosen as one of two to produce Pfizer’s BioNTech-partnered mRNA COVID-19 vaccine – a product that brought in over USD 35 billion in profits last year for the second year in a row –, making it Europe’s first facility to produce an mRNA vaccine at a large scale. Puurs has seen its staff numbers swell from 2,800 pre-pandemic to 4,500 today and, as the company looks to expand its vaccine output beyond COVID, it recently announced a further EUR 1.2 billion investment into the site.
GSK, which has three major vaccine sites (in Wavre, Rixensart and Gembloux) and the global headquarters for its vaccines division in Belgium, also stepped up during the pandemic. While its Sanofi-partnered COVID vaccine did not secure EMA approval until November 2022, purchase agreements for the booster shot have now been agreed with more than 20 EU member states as well as the UK and Canada. Belgium played a key role in this belated success with the adjuvant technology behind the shot developed at the company’s historic R&D site in Rixensart, while one billion doses of adjuvants are produced annually at Wavre, its largest global manufacturing site.
Other key COVID-19 vaccine-related investments in Belgium include Janssen’s R&D centre in Beerse, which worked closely with its global vaccine headquarters across the border in Leiden in the Netherlands on the company’s one-shot jab. Moreover, bioprocessing and formulation services for the Oxford/AstraZeneca COVID-19 vaccine were carried out by CDMO Novasep’s Belgian plant in Seneffe. Added to these Big Pharma efforts were a host of smaller Belgian investments in COVID-19 vaccine R&D and manufacturing, including at the Rega Institute in Leuven, eTheRNA Immunotherapies in Niel, Ziphius Vaccines in Oostkamp, and myNEO in Ghent.
Knock-on Effects and A Host of New Actors
Belgium’s significant vaccine manufacturing and export footprint has knock-on effects throughout the value chain, not least in terms of opportunities for logistics and distribution partners. Tom Hautekiet, CCO of the Port of Antwerp-Bruges, outlines that “We are the first port in the world to be certified as GDP-compliant, so we must learn how to operate as such and deliver to new customers that offer a lot of opportunities, especially considering that Belgium is the second largest global vaccine producer, just behind the US.”
Smaller vaccine-focused firms are also emerging, drawing on the legacy of Big Pharma’s Belgian investments in the field. “The country’s positioning as the pharma valley of Europe is justified, and it has a rich ecosystem with companies like GSK that have significant footprints here as well as several prominent figures in the global health sector,” begins Hugues Bultot, co-founder and CEO of Univercells, a biomanufacturing specialist that provides technology, CDMO, and advisory solutions to its clients. The firm, founded in 2013, partners with the Bill and Melinda Gates Foundation, the Global Health Investments Fund, and other global health stakeholders on decentralised biomanufacturing solutions to improve access to affordable healthcare in regions like Africa and South America.
Belgium has a favourable regulatory environment and infrastructure for clinical trials and advanced manufacturing of therapies and vaccines
Huguel Bultot, Univercells
He continues, “Belgium has a favourable regulatory environment and infrastructure for clinical trials and advanced manufacturing of therapies and vaccines. The country is a key node in global clinical trial supply chains, which allows for efficient testing and validation of new healthcare innovations. Belgium’s expertise in biomanufacturing and its reputation for quality contribute to the advantages of building a life sciences start-up here.”
PDC*line Pharma is another younger company leveraging Belgium’s vaccine expertise and footprint. The immuno-oncology biotech currently has a therapeutic vaccine to treat patients with advanced-stage non-small cell lung cancer in Phase Ib/II clinical trials. “When I joined as CEO in 2016, we decided PDC*line Pharma should be developed in Wallonia, the French-speaking part of Belgium,” says Eric Halioua. “The reason for that decision was that I knew the area and its strong ecosystem already because I had been the CEO of a previous company for six years. It is even stronger now with Big Pharma setting up headquarters here and bringing in a lot of talent. We have benefited from that, and most of our management team came from GSK Vaccines.”
He continues, “Financing is one of the other strengths of Belgium to attract biotech. In Wallonia, for example, a lot of government funding is available, and there are also many VC funds present here. In addition, Belgium is very quick for setting up clinical trials.”
Not only does GSK Vaccines provide a rich pool of talent for other vaccine-focused outfits to draw from, but the company also partners up with innovative local players, thus further bolstering the ecosystem. “Vaccines are [made] using biological components – which can be quite complex to produce at large scale,” states Jamila Louahed, GSK VP, head of therapeutic vaccines R&D and the Rixensart R&D centre.
“We have developed strategic collaborations to help optimise our production processes, like with imec, a leading nanotechnology research centre with headquarters in Flanders, in order to leverage nanoelectronics to automate and improve control processes in biomanufacturing of our vaccines, including those in development phase. This collaboration contributes to consolidate Belgium’s strategic role in vaccine R&D and make Belgium the Health and Biotech valley of tomorrow.”
Domestic Immunisation: Not a Prophet in Their Own Land?
However, while Belgium’s role in developing, producing, and distributing lifesaving vaccines to the world is now better known than ever, pharma industry stakeholders worry that these products remain undervalued at home. “Vaccine hesitancy crept up in Belgium during the pandemic, although not as badly as in some other European countries, and pharma was accused of just wanting to sell vaccines rather than make people better,” laments pharma.be’s Ven. “There needs to be a greater recognition of the economic cost of a pandemic and people not being able to work versus the costs of vaccines, which is far lower.”
Currently, much adult vaccination [in Belgium] depends on the preferences or knowledge of individual patients and doctors, whereas an overarching framework is needed
Emmanuelle Boishardy, GSK BeLux
Most worryingly for Emmanuelle Boishardy, VP and GM of GSK BeLux, Belgium completely lacks an adult immunisation framework and vaccines’ true value on both a health and economic level is not fully appreciated by the Belgian government. “We are pushing to change this,” she asserts. “While discussions can be challenging, especially given the differences between vaccines and treatments, vaccines for adults, like for children, are vital tools with a return on investment (ROI) of four euros to every one euro spent,” she asserts.
“Not only do vaccines protect individuals against infectious diseases, but they also protect against serious complications and aggravation of underlying diseases. All these benefits ultimately translate in a positive economic and societal impact, not the least on health inequities. However, to many in government, they are still seen as a cost rather than an investment and the pharmacoeconomic assessment of vaccine value is still too narrow. For this reason, we need to continue attempting to educate and inform all stakeholders about the broad value of vaccines, including for adults.” She concludes, “Currently, much adult vaccination [in Belgium] depends on the preferences or knowledge of individual patients and doctors, whereas an overarching framework is needed.”
