Global Experts Call for Urgent Reform in Neonatal Medicine

A major new Commission published in The Lancet Child & Adolescent Health has issued a global call to action to transform neonatal care and research.

Global Experts Call for Urgent Reform in Neonatal Medicine

A major new Commission published in The Lancet Child & Adolescent Health has issued a global call to action to transform neonatal care and research, warning that progress has stalled and the current situation continues to fail millions of newborns each year.

The Commission on the Future of Neonatology, co-led by Professor Neena Modi (Imperial College London), Professor Peter Davis (Australia), Professor Satoshi Kusuda (Japan), Professor Steve Abman (USA) and Professor Daniele De Luca (Paris), with contributions from around100 international experts, presents a bold roadmap to re-energise neonatal medicine and address limited innovation and systemic neglect of newborn-specific research.

Despite advances in neonatal care, the report reveals that more than 90% of medicines used in neonatal care are not licensed for newborns. Most are off label, with limited data on safety, effectiveness and dose. Additionally, development of new medicines, diagnostics, and devices for neonates has been chronically underfunded and many fundamental aspects of care such as optimum nutritional, neuroprotective, and immunomodulatory strategies, are uncertain. What neonatal research is done is largely in high-income settings even though the major burden of need is in low- and middle-income settings.

The authors call on policy-makers, funders, regulators, and industry leaders, to act collectively to address the innovation gap, reform regulatory barriers, and implement forward-thinking neonatal health policies. They also emphasise the role of civil society, and parents, patients and families, and local communities in shaping equitable care for newborns.

The Commission recommends a coordinated approach that aligns policy, science, and clinical care to improve global survival and optimise life-long health. The Commissioners argue that investing in neonatal care not only saves lives but also strengthens societies and economies by improving lifelong health.

To facilitate these processes, the Commission proposes the creation of a Global Alliance for Innovation in Newborn Health (GAINH), comprising:

• A Global Financing Facility to create a predictable market for industry
• An international network of Research-Friendly Neonatal Centres committed and supported to deliver high-impact, efficient, cost-effective, clinical studies
• Standards for clinician-scientist career pathways
• A platform for stakeholders to shape research agendas through the establishment of disease specific neonatal advisory groups
• Advocacy to draw the attention of global and local funders, regulators, policy makers, and society to the importance of neonatal research to improve health across the life-course

“Optimisation of the health of every newborn infant should be considered a cornerstone of efforts to improve global population health,” said Professor Neena Modi, Professor of Neonatal Medicine at Imperial College London.

Read the full Commission: The Lancet Commission on the Future of Neonatology