Restricted access to reception undermines health and dignity
Seven organizations are once again sounding the alarm about the consequences of Belgium’s reception policy. In a new report, they show how further restrictions on access to reception since 2025 are directly contributing to health problems, psychological distress, and structural exclusion. From a medical humanitarian perspective, the conclusion is clear: access to reception is inseparable from access to healthcare.
Photos taken in February 2026, when MSF provided medical care during outreach activities in Brussels.
Reception is a key condition for health
Since changes to the Reception Act in 2025, an increasing number of people have been excluded from the reception system. This includes people who already hold a protection status in another EU Member State (the so-called “M status”), as well as certain families whose children submit their own asylum application.
Although individual vulnerabilities are legally meant to be assessed, Doctors Without Borders observes that, in practice, access to reception is becoming increasingly uncertain.
Lack of reception has immediate medical consequences. Without a safe place to sleep, people cannot rest, recover from illness, or properly follow medical treatment. From a medical perspective, reception is not merely a social measure, but a fundamental determinant of health, dignity and human functioning.
Download the report:
Living in uncertainty outside the reception system
Between August and mid-November 2025, 249 people were denied access to reception, including families, women and single men. Fewer than 20% of people with M status gained access to reception following a vulnerability assessment. As of 1 December 2025, 1,759 people were on a waiting list for reception.
According to the teams of Doctors Without Borders, this prolonged uncertainty creates extreme instability in daily life. People are forced to constantly improvise, moving between emergency solutions and humanitarian services, without knowing where they will stay the next day. This instability makes it almost impossible to organize consistent and continuous care.
Fragmented access to healthcare
People who fall outside the reception system also lose structured access to medical, psychological and social support normally provided in reception centers. Instead, they must rely on low threshold humanitarian services, including care supported by Doctors Without Borders.
At the Humanitarian Hub, 85% of medical needs could be met, but 185 people were unable to access care due to limited capacity. From November 2025 onwards, the number of available consultations decreased even further, increasing the level of unmet medical needs. Doctors Without Borders teams also observe that a significant share of consultations is devoted to navigating administrative procedures in order to access healthcare at all, highlighting deep-rooted structural barriers within the healthcare system.
Rising mental health needs, limited support
Levels of psychological stress and mental health problems are clearly rising. Doctors Without Borders teams consistently observe high levels of anxiety, stress and psychological suffering, directly linked to uncertainty, unstable living conditions and a lack of prospects. In humanitarian settings in Brussels, only about half of existing mental health needs can currently be addressed.
Doctors Without Borders provides both individual and group psychological support, including in informal settlements and in contexts where reception is unavailable. A significant part of this work also involves guiding people through complex healthcare and administrative pathways. This underlines how closely mental health is linked to structural exclusion and daily insecurity.
Living conditions leave clear marks on physical health
Medical data and field observations from Doctors Without Borders show a clear link between living conditions and health outcomes. In humanitarian health services, 12% of diagnosed conditions are skin diseases and 8% are respiratory illnesses. Poor hygiene conditions, exposure to cold and damp, and overcrowded or unstable accommodation directly contribute to preventable health problems.
Health, dignity and rights are inseparable
From Doctors Without Borders’ perspective, health cannot be separated from human dignity and fundamental rights. When access to reception is systematically restricted, the consequences are visible: interrupted care pathways, preventable worsening of medical conditions, and growing mental health needs.
This report confirms what humanitarian actors have long observed on the ground: an exclusionary reception policy does not create solutions, but deepens a humanitarian crisis with severe human and medical consequences.
