Testing Transatlantic Shipments of Precision Therapies

Focused on an ambitious, ground-breaking initiative, PTL Gateway, this episode dives deep into the operational testing of transatlantic supply chains for precision therapies, specifically on the Antwerp–Dallas Fort Worth route.

Explore the real-world logistics of precision therapy shipments with guest Freek De Witte, Director of Air Cargo Belgium, and host Frank Van Gelder, Secretary General of Pharma.Aero, discussing the challenges of current airport infrastructure, regulatory hurdles, and the need for specialized protocols to manage low-volume, high-value therapies like ATMPs and radioligand treatments.

 With live shipment trials underway, this episode unpacks how community-driven collaboration, real-time data, and flexible frameworks are helping to shape the future of precision logistics. 

Whether you're a pharma manufacturer, logistics provider, or healthcare stakeholder, this episode offers deep insights into how the industry is preparing to deliver next-generation therapies—efficiently, safely, and at scale.

Transcript

Pharma.Aero Podcast, Insights

Testing Transatlantic Shipments of Precision Therapies

Frank Van Gelder (FVG): A good day everyone and welcome to the next podcast series of Pharma.Aero, the Precision Therapy Gateway Project. We're going to explore the critical intersection of precision therapies and their logistics, as groundbreaking treatments like advanced therapy medicinal products and radioligin therapies offer new hope for patients with complex conditions, ensuring their safe and timely delivery is just as vital as their development. But of course, looking at the current global logistics network, are they truly ready to handle these therapies at scale? Today with me in the room is Mr. Freek de Witte, Director of Air Cargo Belgium, the community platform at Brussels Airport. So, if this system were implemented tomorrow, would the current airport infrastructure be at scale to support it? 

Freek De Witte (FDW): Well, let me be very clear on that one. No. And if I can make a parallel, if I would be buying a new car, I would not be building the garage two, three years before I get the car. I would be planning for it. That's what we're doing, as Air Cargo Belgium, as Brussels Airport, but the garage is not there yet. It would be a waste of money or a bad investment to make sure that you have everything in place even before the market has developed. Also because we see that the market could go in different directions. There's lots of things going on, different type of therapies coming, which have probably have different kind of logistical needs. So in that sense, currently no. But, very important, we're sitting with the architect to plan the garage to see how it should look like, how big it should be. Yeah, we wrote a report as Pharma.Aero, like the first phase of a bigger project, a wider project, that then of course might identify some bottlenecks. 

(FVG): So what do you see, as running a community at the airport and a favorite gateway for Pharma today, what do you see as the real bottlenecks we might face? 

(FDW): I think at this moment in time, we launched a project together with Pharma.Aero. So we have your report, which is already in place. Now we're going to start with some test shipments. from which we hope to get data as well to pinpoint some of the current weaknesses in the system. And then, as Air Cargo Belgium, we're going to take the lead in the third phase of the project. We're going to look at protocol standard operating procedures to see how theoretically this should look like. If we look a bit back and we look at what Brussels Airport in general, but also the community here in Brussels, did when we had similar challenges in the past, we can look at live animals, but they had a few of them, so they didn't have specifically trained staff, they didn't have a specific area of their warehouses where they were treating this, and we saw that the quality was very low. So at a certain moment in time, the airport said, we're going to take the lead, we're going to invest in the hardware, and then we make sure that we have people who are specifically trained to do this. And now this is in place for a few years, the Animal Care and Inspection Centre, and And when you talk to operational stakeholders, you talk to government, everybody says, this is a winning concept. Same could be said about Brinks. Brinks does all the valuable handlings. Also has their separate building, their separate processes. So this is one of the things we're going to look at in the project to see if this is the case. Can we make a business case to have a separate? building or part of an existing building, but with dedicated people to make sure that everything is in place. 

That's one of the bottlenecks. Regulatory is another one. Customs should be aware that they don't see strange shipment which they have never seen before and they say, okay, let's put it aside and let's dive more into detail tomorrow and the day after tomorrow. So I think these are two of the main bottlenecks. The processes with procedures which can be adapted to that, and regulatory environment. 

(FVG): So if we go to phase two then, and the phase two of the project which was recently announced, what I crystallize based on what we just say is that volume and expertise go hand in hand. So if the lower volume, which is characteristic for these shipments, is scattered all over the place, it's very hard to put a central expertise in place, correct? 

(FDW): Correct, so typically we talk about shoebox-sized shipments and we have huge warehouses, ten thousands of square meters. So, just that image alone gives you a bit of an impression, okay, if there's only one person in the chain who says, I don't know what this is about, let me check into later… And we all know how operational processes run at the airport, it’s easy to be rushed into what you are doing that day, making sure we have the big shipments which go out, and let's say, forget between brackets.. If I take a few steps back, because one of the supporters of the project is also the province of Vlaams - Brabant, together with the province of Antwerp. They already pre -invested or gave a lot of support to the community. The first one was purely based on airside hardware. So the airside pharma transporters, they said, that’s a missing piece of hardware. Then we had the COVID -19 crisis when they said, okay, we're missing a control tower concept, but there you still had huge air freight pallets full going to one destination. Now we make it even much more complex because these are very valuable shipments, very small and going to all kinds of different destinations. So we need to take it to the next level. 

(FVG): I know that a lot of times when something new comes to the market, there's a lot of commercial window dressing. Wow. great, something new, something really challenging, but I think evidence -based is important in this case because the impact of the therapy and the logistics with it is directly driven to the patient, being it successful or not. So how are you going to prove what you need to do? Are you going to do like a test of the gateways or what is in the pipeline there? 

(FDW): So currently we have where we ask them to ship it as the process and the procedures are now. So that's going to give us some information and then typically I think one of the benefits of working with the community is that you don't talk about commercial products, you don't talk about rates, you don't talk about all the other things but you typically are what they call in air traffic control just culture. Meaning we do the shipments and then we are very open on what went Typically, in a project, you can look at those kind of aspects and be very open with each other to say, these are the things which are working and these are the things which are not working. And then we need to look at special handling codes, operating procedures. Then we need to develop them and make sure we get adoption. And when it comes to these kind of things, there's several options. You could go the IATA way, you have tons of others. So there we need to look which are best fit for purpose on that. 

(FVG): So actually you're going to analyse the situation just like it is today, and then from there you map your findings, and then based on the findings you map, you will come up then with a protocol and probably also a label that meets, because there is no international labour, right? 

(FDW): Correct. So let's make the analysis and then see which kind of tools we need, and it might be that we need some new tools, or that we start with a few tools and then we see after a year. But to come with one of the concepts of Jeff Bezos, you need to go fast. So don't wait until you have 90 percent of the information. You take a decision when you have 70 percent, but make sure we have short feedback loops during the process. So let's start and then see what works, works. We keep it. What doesn't work? We need to make sure that we're ready to make those adjustments. 

(FVG): Interesting. I think just a bit on the side path to set up a study with 150+ shipments to do that objectively. I think collaboration of a community is essential, I don't know. I think you are the director of a community. Brussels Airport is famous for years already for pushing healthcare and pharmaceutical mindset, I would say, but how did you do this? 

(FDW): We, let's say, I would not say we come at the end, but we are maybe the glue which ties everything together but Pharma.Aero was, let's say, for me, the inspirator saying this is coming to market and that's one of the things why is Brussels Airport the main pharma hub in Europe because they really allow their people to go really deep into the sector they really know okay what's coming towards us and this is something which the rest of the community has less make sure that we have a bit of a forward vision. What we did as Air Cargo Belgium, once in a while we organized the cargo talks where we invited some medical players who came there as well to talk, to open the eyes of the community, this is coming, and gradually get them ready. So Brussels Airport, being that much focused on the sector, already having that kind of knowledge, they knew we need to take some steps. And that's where we as a community, we can bring everybody together and make sure that we align in that direction. Interesting. 

(FVG): So actually, you're designing the framework of what I would call the ATMP RLT ecosystem, right? All the circles around the circle of the nucleus of this of these therapies. OK, let's be for the listeners a bit more concrete. You have read that it's super important to do something. Two, you're going to test what you need to do. Let us say I'm tomorrow a patient. I'm awaiting my oncology treatment, life -saving. I'm one of the many thousands in the country. What would you tell us what you would do concrete, different than what you would do today? 

(FDW): One of the elements of the business case we're looking at, it's clear that once products are flying, The plane cannot go that much faster. Most of the time they land at the airport where they need to land. So it's first and last mile, and especially the last mile. So how can we eliminate the risk of the last mile? One of the things could be to bring the patient to the airport instead of the product to the patient. That's one of the concepts we're looking at. Is there a business case for that or not? More and more it's, I would not say self -medication at home, but under supervision, digital supervision, For me, this is kind of the same concept, but then specifically for ATMP or precision therapy. So why don't we bring the patient to the airport? At the patient, we are sure the patient is already there at the moment the shipment arrives. And so there's no last mile, no time delays. And I think with the constraints already on the healthcare system in Belgium, but also globally, to take that approach, I think it's much easier for us. to have a few health care professionals at a specific location at the airport, close to the airport, where they can look at these kind of things, where they can administer the medication rather than inserting it into the huge hospital systems which are already in place and which are already overburdened at this moment in time. So it's like a decompression move of the chronic pressure on the health care system, right? On the health care system and on the logistics system. There's no need to take the box, really rush it, make sure it's in traffic and then see, do we get it there at the moment? No. We know we bring the patients here, we give them some leeway so that it's not just in time from both sides. We make sure the patient is already here and then the shipment is coming. 

(FVG): And that, if I may say, that is one of these solutions, right? Now we have the CAR-T own cell treatment versus other cell treatments or genetic treatments. So it is one of the plug -and -play elements in a wider scope? 

(FDW): Yes, 100 % correct. So when I'm going back to the parallel of the garage, what do we need to build? It's not clear at this moment in time which of those therapies will be the best. winning, if they all stay, if there's going to be one which is dominant or not. So we can build the framework, we can plan for a few things, but then later on we'll have to be able to adapt to maybe Radio Ligand going very big, very soon, but and some others might take some more time. So we need to be able to have that flexibility, because if we don't, It's a huge investment as an airport, specifically in hardware, but also for the community to make sure they have trained people. So you're not going to train them for products which are not common. 

(FVG): If you would have to make a statement or a quote, a lot of things are set currently around ATMP, cell engine. So we should definitely not lose track on what we're already doing, right? I need to make a quote, I'm a patient listening to this podcast, I download this, I listen. What is your major element you would address to the patients that are tomorrow will get this treatment? 

(FDW): Let's take a small side step to e -commerce, because the transparency, the visibility. A few years ago, nobody would think that we have that kind of visibility and transparency when you order it, that you have order confirmation, that you see when it's coming your way, and that they can say, within those 30 minutes, we're going to deliver it to your door. So that's for very cheap products already. Now we made that step, because that market is already there. If you look at that kind of process, this is exactly and even much more what we need for precision therapy. because these shipments are much more important, much more expensive and much more life -saving than small e -commerce shipments. So if we can manage to have that kind of process set into place for precision therapy, that's where we as logistics sector will be able to help and the patients and the medical sector to make sure that we deliver these precision therapies as they are needed. 

(FVG): It's amazing what a visionary position you already take as an airport in Air Cargo Belgium to go and look already ahead of what might be coming. So with these words I would like to thank you, Freek de Witte, Director of Air Cargo Belgium, for sharing insights on the next steps to be taken. And I would also like to thank all the listeners of the podcast and the members of Pharma.Aero for being here and listening to this insightful podcast. And with this, I wish you a very nice day. My name is Frank Van Gelder, Secretary General, Pharma.Aero. Thank you very much. 

Insights, a podcast by Pharma.Aero.