Health Cluster Portugal is currently spearheading a EUR 90 million EU post-COVID Recovery and Resilience Plan (RRP) project in Portugal focused on smart health, secondary use of data, and clinical trials. Executive Director Joaquim Cunha highlights the ways in which COVID acted as a catalyst for healthcare transformation more broadly, how the organisation has evolved in recent years, and the most significant opportunities ahead for Portugal.


Can you start with an overview of Health Cluster Portugal and how it has evolved since we last interviewed you in 2018?

HCP is an association that brings together the health value chain across Portugal. We have 228 members today, coming from major universities; the R&D institutes that are connected to these universities; university hospitals, which are the biggest in the country; major private groups of hospitals, and the hospitals from the social sector. We also include pharmaceutical, medical technology, and other companies. In the pharmaceutical area and in medtech, there are both local and international players. Other kinds of companies include service providers in areas like technology, as well as some smaller companies, such as start-ups and spinoffs.

We are probably the only association that is not actually involved in the interests of its members as they all have their own agendas and there are conflicts of interest between them. Some of them are competitors and others are on the opposite sides of the game with different goals. The objective and target of the cluster has always been to give the Portuguese citizens the best possible health outcomes and provide value for the people here.

Over the last 15 years, we have become more of a lobby organisation for the people to bring to the national agenda the issues we think are important for the benefit of health as a whole in the nation. Within healthcare, we are facing big challenges and the long-term sustainability of the healthcare model we have across Europe is under threat. We really have to think of a new way of undertaking healthcare. The national healthcare systems across Europe were built after the Second World War and at that time the medical issues people faced were acute.

Now, as treatments become better and people live longer, the world is facing chronic disease. Where money is spent today is different from the past and we need to evolve with these demands. Previously, hospitals were the core of the healthcare system, but today maybe that is not the best approach. The development and introduction of new technologies and the use of data have changed the game, although healthcare has historically always been very slow in adapting to the times.


Since we last spoke, the world has endured COVID-19, and many have seen the pandemic as an inflexion point to reshape how we address healthcare. What is your perspective?

I agree with those who saw COVID-19 as a moment of reflection about healthcare. All over the world, we panicked as we thought we were living in a brave new world and the next second we were locked up in our homes. Besides the panic, there was a debate about health: what was working well and not so well, and what more could be done. Technology and science came out as the answer. The use of technologies and digitization was a huge milestone for us and one of the most important changes we have ever made in healthcare in Portugal.

COVID-19 also served as a catalyst for innovation acceleration and it showed the importance of science. It is crazy to think that the world was saved by a biotechnology company. It is fantastic to show how the relationships within the pharmaceutical industry led to the vaccine and how innovation can lead to amazing discoveries.


Portugal has received considerable funding from the European Commission for its post-COVID Recovery and Resilience Plan. How will these funds impact the country’s healthcare ecosystem?

This was one of the positive consequences of the pandemic as we now have a lot of funds, nearly EUR 500 million, for health-related projects. These funds will be directed towards innovative projects, both private and public, relating to introducing and updating health digitalisation. If in 2027, after spending all this money, our health system is not different than today, then we would have done something incredibly wrong and we would be guilty of throwing the money away. It is a tremendous opportunity and we, in Health Cluster Portugal, are deeply involved in one of these Recovery and Resilience Plan (RRP) projects focused on smart health, secondary use of data, and clinical trials with a budget of 90 million euros,

Before obtaining these funds, we only had small projects, but we need to shake up the ecosystem and even with a lot of small projects we cannot make the same impact as such a large concentrated effort. Things can go wrong and managing a project with 80 partners and such a large budget can be challenging, but we must take risks to transform what we have. Now, we have the opportunity to turn a bad situation into a great success. It is in our hands. We have the money. We have no excuses.


Portugal has many world-renowned researchers yet the country is not known as a hub for innovation. What is your view of innovation coming out of Portugal?

We do have a nice basic research ecosystem with good scientists, but we are not great at turning that innovation into profits and services for the market. I think this needs to change not only in Portugal. It is a European problem when compared to the markets like Asia and the US.

One of the subprojects in the RRP initiative mentioned above is looking at how to be more operational and market-orientated, such as setting up a Portuguese health business that gives Portuguese products and services a market to sell across the globe. We need to invest and persist with a change towards a more business-driven culture, such as having R&D projects that are structured around a business ecosystem.

Something we have experienced is that change only happens when you make a connection with business and investment. We get a lot of public funds that are given to our researchers with no endpoint. We need to change that mindset and have some financial output. Things are changing but again, for such a big shift in mindset, a large shakeup is required. We can have both: excellent basic research and research driven by the market.


Might the new generation have a part to play in this, especially as some of the Portuguese talent that went abroad is now coming back to live and work in Portugal?

15 years ago, I gave a speech to the big research institutes about business and the need to move towards a market mindset. It was not well-received – I was looked at as strange. Today, this has completely changed and when I talk to my colleagues at these institutes, they talk about being connected with pharmaceutical and medtech global and national companies. We are moving in that direction but slowly. We need to speed up.


Which globally competitive healthcare areas do you believe Portugal can carve out a space for itself?

One of the areas is smart healthcare and the use of Information Technology (IT) and Artificial Intelligence (AI). We have a strong background in other fields using these new technologies and they are being brought into healthcare more and more. Furthermore, I see some niches within oncology and neuroscience where we can do well.


You have been with Health Cluster Portugal for 15 years. Looking into the future, what would you like to achieve going forward?

The consolidation of the projects I mentioned. We want our fellow citizens to see healthcare as an economic sector that generates good jobs and adds value to the nation’s gross domestic product (GDP). People involved in healthcare already know this, but it needs to be seen from the outside by the Portuguese people and that is a big challenge.

Furthermore, it would be great to see smart health being pushed more. When you look at the healthcare exports coming from Portugal, they are mostly medical devices, and smart health only represents small figures. We have some start-ups, but we should have a subcluster related to smart health and this could be a turning point to making us a hub for innovation in other areas.