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Health Systems

How to strengthen health systems across Europe to respond to pandemics? How to enhance their preparedness and resilience? What can we learn from different COVID-19 outbreak responses across Europe and the social and economic impact? Athena tries to unravel these and more questions within the field of health systems, related to COVID-19. The below pillars make our approach unique:


  • System thinking and comparative analysis of health policies and systems: System thinking can help policymakers to better understand key outcome indicators (such as ‘confirmed cases’, 'case fatality rates' and ‘mortality rates’) and the societal and economic impact. The context of European countries is often overlooked in the presentation of COVID-19 data as are different stakeholders, their interests and their influence on the type of responses proposed. The society is a complex adaptive system; a system approach can help to contextualize data to better prevent and respond to COVID-19. (reference 1Over the past 20 years, the Athena Institute has built a broad line of research in the areas of health systems, policy making and implementation and the role of community and patient engagement in (researching) health systems. We offer courses such as 'International Comparative Analyses of Health Care Systems’ and “Governance of Global Health' at master’s level.   

  • Transdisciplinary and participatory action research is a concept where the owners of the research project are not only the researchers, but also other relevant stakeholders/end-users such as health authorities, care delivery organisations, civil society organisations, as well as the public. The aim is not only to co-create knowledge to inform contextualised solutions to societal challenges, but also to have a transformative effect on the area of research. With an established methodology, stakeholders are involved in various phases of the research project. An example to these is the Interactive Learning and Action (ILA) approach, which has been developed by Athena Institute as a methodology to bring societal stakeholders into a science and technology development process. (references 2 and 3)

  • Commitment to equality and inclusion: The Athena Institute brings experience with the inclusion of seldom heard and hard to reach groups in decision-making processes. We have developed various methodologies in the field of inclusion and have built a broad range of expertise in working with vulnerable groups. COVID-19 raises ethical questions and potential health inequalities. An inclusive research approach is a process of addressing and responding to the diversity of needs of all citizens.

  • International team and research experience: The Athena Institute is a research group with expertise in for example epidemiology, citizen science, health systems, communication, social sciences, and with experience in conducting research in low-, middle- and high-income countries. At this point, Athena contributes to COVID-19 research and decision-making processes in various countries (e.g. The Netherlands, Turkey and Italy). Athena's prof. dr. Aura Timen is an endowed Professor at the VU. She is also a member of the Dutch Outbreak Management Team and Head Coordination Communicable Disease Control at the Dutch National Institute for Public Health and the Environment.


Health Systems

Mental Health


In the past years, Athena institute has been strengthening the research on transdisciplinary mental health within the Global Context. Within the research special attention is being paid to the bio-psycho-social aspect of the mental health issues as well as the role of the environment as the risk factor as well as rehabilitation strengthening factor. 

The research in the mental health field has been taking place in multiple settings: primary prevention, diagnostic field and the area of rehabilitation. Special attention is being paid to mental health disabilities (among others Autism Spectrum Disorder). 

Among the projects on mental health are: 

  • Long-standing collaboration with the Banyan NGO in India

  • Health-related stigma in Indonesia 

  • Support for Autistic females in the Netherlands

  • Potential of use of technology to increase employability of people with mild intellectual disabilities in the Netherlands (UWV)

  • Employability of people with psycho-social disability in Kenya

  • Career support for Autistic University students in Europe (IMAGE project)

  • Collaboration with the Brain Blocks tool in the Netherlands

  • Investigation of Orthorexia Nervosa (a new suggested disordered eating pattern)


Additionally, research is taking place in many various contexts and countries. Among them are: the Netherlands, UK, Germany, India, Indonesia.

Due to the vast experience in the field of global mental health, Athena has been offering a highly successful summer school: The Beautiful Mind: Global Perceptions of Mental Health.

Athena is currently taking part in a large, international research activity, which compares the effects of the COVID-19 crisis on the mental health of students in The Netherlands, Finland, Germany, Italy and  Ukraine. The goal is to investigate the well-being of young adults (university students) as the times of COVID-19 from a bio-psycho-social perspectives. The survey has been distributed and we are currently collecting the data.

Another project we are working on addresses stigma and discrimination related to the COVID-19 pandemic, using lessons learned from Ebola and HIV/AIDS. While stigma and discrimination surrounding the spread of the novel coronavirus disease is now rampant across the world, this is not the first time a disease epidemic and the pandemonium associated with it has fueled such stigma. In this study we use evidence of successful stigma responses from Ebola and HIV/AIDS epidemics and strategically analyze how the lessons learnt from these epidemics can offer help in addressing stigma and discrimination associated with the COVID-19 pandemic.


Mental Health

Innovation Systems


To protect our health and wellbeing, it is of great importance that we are prepared to recognize and respond to threats of new or re-emerging infectious diseases. With public health interventions, and with dedicated innovation efforts. 

Role of innovation systems
Effective and timely innovation is highly dependent on the existence of efficient innovation systems. Scientists, governments and companies all contribute to these innovation systems by setting research agendas, mobilizing resources, developing and diffusing knowledge, translating knowledge into innovations through entrepreneurship, creating legitimacy of new innovations and forming new markets. 

Barriers to effective and efficient innovation
Such collaboration is not always self-evident or efficient, however. The Nagoya Protocol on Access and Benefit Sharing requires users to negotiate the terms and conditions under which they gain access to genetic resources with the governments from which those resources originate. Such negotiations are time-consuming. In addition, actors have at times conflicting interests, informed by systemic incentives, such as publication priority and prior art restrictions for patent applications. 

Societal engagement
Moreover, innovation as technology-push is only one side of the story, and often encounters a range of innovation barriers and resistance in society. Prominent examples in the life sciences include vaccine hesitancy, “not in my backyard” or “not in anyone’s backyard” responses to genetically modified organisms, and failed adoption of many eHealth initiatives. Society’s perspective should therefore be taken into account in an early stage to inform responsible research and innovation in a market-pull fashion.  

Athena’s educational progams
Athena’s educational programs provide in-depth insight into the dynamics of innovation systems and how science and technology interact with society (e.g. Managing Science and Technology in Society). They also go in-depth into the specifics of innovation in health and life sciences, by outlining business and entrepreneurial aspects (e.g. Business Management in Health and Life Sciences and Societal Entrepreneurship in Health and Life Sciences) and the specifics of clinical trials (e.g. Clinical Development and Clinical Trials).

Athena’s research contributions
Athena’s research directly fits with these perspectives as well. 

Outbreak-specific research

  • After the SARS outbreak, Athena provided insight into the use of patent pools to bring different innovative efforts together. (reference 1)

  • In collaboration with RIVM, Erasmus MC and the CDC in Qatar, Athena was involved in a case study looking into barriers for data sharing in the MerS-CoV outbreak, starting in 2012, in Qatar. (reference 2)

  • Analyzing responses to early Ebola outbreaks, Athena found a difference between self-centric and altruistic motives to contribute to innovation. (reference 3)

  • In a letter to the editor of Science, Athena discussed the importance of rethinking mechanisms to engage public-private partnership in early-stage research on emerging pathogens. (reference 4)

  • In Science, we explain how developments in blockchain technology may help to overcome barriers to rapid exchange of research data and materials between scientists, governments and companies worldwide, for the development of vaccines, diagnostics, medicines and effective public health action in response to outbreaks. (reference 9)

  • We identified and visualized innovation barriers that increase vaccine development timelines, revealed their underlying causes and prioritized their impact on both regular, and Covid-19 vaccine development timelines. (reference 10)

  • The current covid-19 pandemic, and the shortage of vaccines has re-ignited long-standing debates on the societal impact of the patent system. Should compulsory licensing be enforced upon industry manufacturing vaccines? We wrote an editorial on this debate, providing an overview of commonly heard views and beliefs on the positive ánd negative impact of patenting across pharma-nutrition industries, for society at large. (reference 11)


Innovation systems research

  • Building upon earlier conceptual contributions, Athena designed a stage-gate model contributing to improved process efficiency in vaccine innovation. (reference 5)

  • Studying the progress of the innovation system as a whole, Athena provided insight into the current state of development of genetically modified systems. (reference 6)


Stakeholder collaboration

  • Building upon insights from adjacent fields, Athena studied the impact of the Nagoya Protocol on sample sharing. (reference 7)

  • In collaboration with RIVM and Erasmus MC, Athena furthermore investigated how ownership rights, as enforced by the Nagoya Protocol, affect infectious disease control and innovation. (reference 8)


Innovation Sytems


Q&A on COVID-19 by Aura Timen at NOS

28-04-20     Language: Dutch     Timing: 5:58 - 24:30 and from 56:00 onward

What is the current status of COVID-19 vaccine development? To what extend do masks protect against infection? What can we expect from a second wave? The corona virus and the measures that are taken to fight this pandemic have raised many questions. The NOS invited Athena's prof. dr. Aura Timen, member of the Outbreak Management Team and Head Coordination Communicable Disease Control at RIVM, to respond to these questions during a live Q&A.

08-04-20        Language: Dutch        View time: 2:58 minutes     

Aura Timen on the RIVM's recommended measures at Op1

25-03-20        Language: Dutch        View time: 11:41 minutes          

Athena's prof. dr. Aura Timen, Head of the National Coordination Centre for Communicable Disease Control at the RIVM, explains the importance of social distancing and why we can be cautiously optimistic about the decreasing number of new COVID-19 infections in the Netherlands at Op1.

08-04-20        Language: Dutch        View time: 2:17 minutes     

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