ZOASTs - seven zones of organised access to cross-border healthcare


Seven areas of organised access to cross-border healthcare (ZOASTs) were created alongside the Franco-Belgian border area between 2008 and 2015. The patients in those health zones can receive care on both sides of the border without any administrative or financial barriers.


Belgium, France


The Interreg programmes I, II, III and IV have provided a lot of support and technical assistance to the local partners at the Franco-Belgian border to develop, embed and secure structured cooperation, in particular by encouraging inter-hospital agreements and defining a first cross-border health area.

To push the cooperative approach forward and to legitimise it at the highest level, the idea of a framework agreement on cross-border healthcare cooperation between France and Belgium was born. The healthcare treaty, signed on 1 June 2005 by the French and Belgian health ministers on behalf of the two governments, gives the power to the regional authorities in charge of planning, organising and financing the healthcare system to negotiate and validate agreements.

The Franco-Belgian framework agreement has been the legal basis for the seven ZOASTs regulatory arrangements. The ZOASTs, covering today the whole border, enable the pooling of resources and techniques in order to develop a wide range of care accessible to the population of the defined legal zone without any administrative or financial difficulties. They have become benchmarks for cross-border healthcare cooperation across Europe.


In 2015, some 20,000 French and Belgian patients have received treatment without discrimination on either side of the Franco-Belgian border under these cross-border arrangements.