Health Impact Coalition (HICO)
Fragmentation and parallelism are all too often the norm in international cooperation. The Health Impact Coalition (HICO) wants to radically move away from that. Eight recognized Belgian NGOs active in healthcare in the Global South are joining forces in an innovative collaboration model. Their goal: to achieve more structural health impact through strategic collaboration, shared structures and joint positioning.
What started as informal consultation between directors quickly evolved into a project with solid foundations. With the support of S&L Impact, the coalition succeeded in drawing up a strategic framework, shared governance, operational work structures and an initial implementation plan. The organizations want to present one joint program in 2027. An ambitious process - and at the same time a necessary step in a sector that needs more cooperation and visible results.
From fragmentation to synergy
The strength of the HICO lies in its substantive starting point. All participating organizations - including Memisa, Doctors Without Vacation and other established players - share the belief that healthcare is only sustainably strengthened if it starts from systems thinking. Instead of setting up separate programs in the same regions, the partners want to work together on the entire healthcare chain: from health post to hospital, from capacity building to policy advocacy.
Elies Van Belle (Memisa) explains: "We are complementary. Some of us work in hospitals, others in primary care, training or policy advocacy. Together we can connect these links into a solid whole. That makes our joint efforts more efficient and relevant."
This complementarity also translates into concrete practice. The collaboration resulted in a partnership around pediatric care in a number of countries, in which Memisa, Doctors Without Vacation and Keten van Hoop België (Chaine de l'espoir Belgique) coordinate their expertise.
For Stefaan Bonte (AZV) this is exemplary of what HICO wants to achieve: “We do not start from a structure, but from the needs in the field and the realization that collaboration makes the difference.”
“We connect links in the healthcare system. This systemic approach makes collaboration essential.”
A solid foundation for shared strategy
The collaboration took shape through a steering group of directors, three active working groups and the appointment of a coordinator. Parallel became one Memorandum of Understanding drawn up, in which agreements on governance, shared responsibilities and financial modalities for the start-up phase are laid down. This structure allows you to remain flexible, without sacrificing clarity.
HIC now works on three tracks: a joint one DGD application for the 2027–2031 program cycle , the development of shared services for back office support , and a clear communication strategy , aimed at the general public but also at stakeholders such as DGD, Enabel, the Institute for Tropical Medicine and European partners. At the same time, we are working on a mapping of who is active where, with what expertise. This analysis is crucial to strategically organize cooperation per country or theme.
The strategic role of S&L
To combine speed and support, HICO called on the external guidance of S&L. Koenraad Depauw and Jeroen Van Hove supervised the entire process: from vision formation to setting up work structures and facilitating shared decision-making. With a strong methodology and thanks to their experience with coalitions, they were able to create an atmosphere of trust in the group and achieve results in a very short time.
Elies Van Belle looks back on that collaboration with satisfaction: "The guidance from S&L really helped us to make supported choices in a short time. Without them, we would still be in a phase of declarations of intent. Now we have a clear framework and a feasible roadmap."
Also Stefaan Bonte emphasizes the added value of the external view: “S&L brought direction to a complex process. They respected our individuality, but also challenged us to think further together than we would do separately.”
S&L's approach was pragmatic and phased. First, a strategic framework and ambition were defined together with the steering group. This was followed by concretization in work structures, agreement frameworks and the preparation of the recruitment of a coordinator. At all times, the support was aimed at strengthening ownership within the group, without sacrificing speed or sharpness.
“Without the external guidance of S&L, we would not have been able to achieve this pace and quality.”
Looking ahead: shared power in progress
With the foundation now firmly established, HICO focuses on execution. The possibility of shared services - such as legal support, ICT, integrity, travel management - is being further developed. Local consultations for the joint program proposals are starting. And towards 2026, a public moment will be rolled out to also put the collaboration in the spotlight externally.
Yet the ambition continues to extend beyond the DGD program cycle. HICO is intended as an open model: organizations retain their autonomy, but enter a shared process that leaves room for nuance, flexibility and future expansion. Or as Stefaan summarizes: “We are not building a closed ecosystem, but a working model in which collaboration becomes self-evident, agile and scalable.”
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