The root cause of this slow vaccination rollout? Everyone in the broader healthcare sector wants to do it on their own. RIVM, GGD, VWS, Care and Cure,^primary and^secondary care—they’re largely autonomous islands. Local implementation chooses over national coordination, and it chooses not to collaborate with competent third parties such as the Ministry of Defense. In many places, we’re reinventing the wheel. And there is fragmented logistics between procurement, inventory management, and the vaccination teams or sites. Sluggishness is the logical consequence. And that is now costing many people their lives and their quality of life.

This slow pace of vaccination lays bare a key aspect of the healthcare system. The healthcare landscape is highly fragmented, lacking scale and collaboration. Here’s why: healthcare is organized primarily by specialty, not as a continuum. Virtually every institution, department, division, and so on, takes responsibility—but only within its own field. And that responsibility is limited to its own little box, its own silo. This is a systemic characteristic perpetuated by the professional autonomy of medical specialists and the funding system, which is based on those same silos. There is also a lack of a national (IT) technical infrastructure. This doesn’t help; guidance is provided solely through clinical guidelines and the budgets of health insurers.