Summary

Neonatal mortality remains unacceptably high throughout the world. Survival of sick infants in their first month of life has improved over the past six decades. However, many comorbidities persist, with lifelong implications for health. The current ecosystem for research and development of drugs and medical devices to treat neonatal disorders is hindering further improvements to neonatal outcomes, especially infants born preterm or needing critical care. Innovation is lagging, and this is a public health problem characterised by multifactorial challenges in leadership, collaboration, regulation, funding, and commercial viability. The Lancet Child & Adolescent Health Commission on the future of neonatology was created to consider these challenges and design a roadmap of strategies to accelerate research and development that will innovate and improve health care for neonates. We call for regulatory agencies, governments, funders, industry partners, and clinical researchers from diverse medical fields to invest in effective pathways for drug and medical device development and to unite in responsive and dynamic collaborations with diverse patients, families, and advocacy groups whose engagement in clinical research and advocacy can help neonatologists to achieve the best science and health equity for neonates worldwide, now and in the future.

De Luca, D., et al. (2025). The Lancet Child & Adolescent Health Commission on the future of neonatology. The Lancet Child & Adolescent Health, 9(8), 578–612. https://doi.org/10.1016/S2352-4642(25)00106-3