Children’s health is a major societal challenge for Europe and the world, requiring development of paediatric medicines and treatments strategies based on evidence derived from clinical trials demonstrating efficacy and safety in infants and children, rather than on uncritical extrapolation from adult data (over 50 % of the medicines used for children had not been tested in this specific age group). Conducting clinical trials in children requires specific competences and infrastructure. ECRIN-ERIC (www.ecrin.org) is a generic infrastructure for multinational trial management, in any disease area. However it does not specifically address the paediatric needs in terms of trial management capacity. In its 2016 Roadmap, ESFRI suggested an upgrade of ECRIN to develop a common infrastructure for paediatric trial management through cooperation with the European Paediatric Clinical Trial Research Infrastructure (EPCTRI). The resulting PedCRIN project is also a unique opportunity to improve ECRIN business model and financial sustainability, attracting more industry-sponsored trials and more Member and Observer countries. PedCRIN builds on five work packages : project coordination (WP1); establishment of a strategy and upgrade of the governance and business plan, through a Sustainability Board jointly involving the scientific partners and the government representatives (WP2); development of tools specific for paediatric and neonatal trials (WP3) (methodology, outcome measures, adverse event reporting, bio-sample management, ethical and regulatory database, monitoring, quality and certification); operational support provided as transnational access to a few pilot trials to test the updated organisation and tools (WP4); communication targeting user’s communities (including industry), policymakers, patient and parents’ empowerment (WP5). Two other ESFRI-landmarks, BBMRI-ERIC and EATRIS ERIC, will contribute to PedCRIN.

The overall objective of this 5-year project is to build a multinational, adaptive European COVID-19 and emerging infectious diseases trial network, based on existing initiatives, experience and expertise, allowing European expansion of DisCoVeRy (WP1) and the establishment of a COVID19 adaptive platform trial (WP2). The DisCoVeRy trial, designed as a multi-arm adaptive repurposing trial, initiated in France, has the potential to expand to many other European countries with appropriate support in terms of multinational funding and trial management capacity. This will complete the evaluation of repurposed drugs, while building a European clinical trial network which, together with other European networks such as the Solidarity trial, will design and run a new European platform trial. EU-RESPONSE will swiftly generate robust evidence for drug repurposing or registration, through a modular trial framework allowing most European hospitals to participate at their preferred level of commitment, thus building a network of investigation sites within European and associated countries. Cooperation with other European platforms, in particular the RECOVER consortium platform will be achieved through a joint coordination mechanism aligned with European and national policies (WP3), ensuring a coordinated strategy for the European COVID-19 Adaptive Platform Trials, their complementarity in providing access for requests for a new domain or arm, their synergy and cross-fertilization through the development of a common toolbox for the development and the management of Adaptive Platform Trials. Joining forces in Europe and with international partners, it will contribute to the global clinical trial capacity for urgently meeting the expectations of society and developers. It will also boost multinational cooperation in Europe and promote the establishment of adaptive platform trials in other diseases, and will have a major impact on epidemic control.

The general objective of this project is to design the framework for the European Paediatric Translational Research Infrastructure (EPTRI), a new Research Infrastructure (RI) aimed to enhance technology-driven paediatric research in discovery and early development phases to be translated into clinical research and paediatric use of medicines. The starting point of the proposal is the serious lack of medicines for children in EU and worldwide as well as the lack of a developmental model for paediatric medicines that integrates technology-driven aspects with the methodological, ethical and regulatory framework. The design for this new RI will be based on the following main pillars: • to harness efficiency and delivery of paediatric research activities and services strengthening collaboration within the scientific paediatric community; • to be a complementary RI in the context of the existing RIs covering the current gaps, while avoiding any duplication; • to develop a one-stop-shop for advice in paediatric drug development. To prepare a valuable Conceptual Design Report (CDR), the project encompasses three phases. During the Context Analysis phase, that will be performed in 5 technical and scientific domains (1- Paediatric Medicines Discovery, 2- Paediatric Biomarkers and Biosamples, 3-Developmental Pharmacology, 4-Paediatric Medicines Formulations and Medical Devices, 5- Underpinning Medicines Development to Paediatric Clinical Studies) the perceived value and the possible gaps to be covered will be estimated by enquiring the scientific communities and many other Stakeholders. During the Operational phase, the different components of the new RI will be depicted including governance model strategies for interaction with national Authorities and the existing RIs, the IT-architecture model, services to be provided and a business plan. Finally, a Feasibility phase is proposed to develop virtual exercises simulating the operations of the RI. The final result of the project will be the CDR to realize EPTRI.