The Belgian Court of Audit has examined how Sciensano has managed health data, notably during the COVID-19 crisis. It has also analysed the institutional framework applying to Sciensano’s activities. The significant fragmentation of health competences has been detrimental to an overall management of Sciensano’s activities and funding. The platform Healthdata.be, managed by Sciensano, has only partially succeeded in centralising health data and reducing the workload for data providers. The platform’s activities should also be better supervised. Moreover, the COVID-19 crisis has highlighted the importance of strengthening and sustaining the monitoring and collection infrastructure needed to contain health risks and identify future threats to public health. Finally, the accessibility of health data and statistics to researchers has remained an important issue, which has insufficiently been tackled in the legislative, regulatory and contractual texts governing Sciensano's data collection. There also remains other obstacles to making these data more accessible, including the fact that they are not recognised as public statistics.