Innovation has long been the driving force behind improvements in healthcare, offering new treatments, technological advancements, and digital solutions that can transform lives. Yet, in paediatric healthcare, the path from innovation to implementation remains complex and fragmented. Despite the rapid advancements in medical technology, children continue to have limited access to the latest healthcare solutions. The adoption of innovation in paediatric settings is significantly slower than in adult healthcare, leaving a gap that urgently needs to be addressed. Moreover, children are not just “small adults”—their physiology, development, and disease progression differ fundamentally from those of adults. Many serious paediatric diseases arise from development-related issues and are often genetic in nature. In contrast, diseases in adults frequently stem from epigenetic changes and age-related alterations. This fundamental distinction underscores the necessity for paediatric-specific research and innovation rather than adapting adult medical advancements for children. To bridge this gap, targeted research and innovation must be prioritized to address the unique healthcare needs of children. Paediatric-focused advancements in medical technology, pharmaceuticals, and digital health solutions should be encouraged to ensure timely and effective care. Collaborative efforts among healthcare providers, researchers, policymakers, and industry leaders are essential to accelerate the adoption of paediatric innovations. The challenges that exist are well known: high development costs, complex regulatory pathways, and a lack of specific procurement frameworks tailored to paediatric needs. A striking example of this disparity is the limited adoption of paediatric-specific medical devices. Data shows that while the regulatory landscape has evolved to support medical advancements, only a small fraction of new devices and treatments designed for children ever make it to widespread clinical use. As a result, paediatric hospitals often rely on outdated or repurposed adult solutions that may not be ideally suited for young patients. At SJD Barcelona Children’s Hospital, one of Europe’s leading paediatric centres, we have witnessed first-hand both the transformative potential of medical innovation as well as the systemic barriers preventing its adoption. Addressing this challenge requires a paradigm shift—a move from reactive, fragmented procurement processes to a proactive, structured approach that prioritises the real needs of paediatric healthcare providers and patients. This is precisely the vision behind the ADD4KIDS project. By leveraging demand-driven funding mechanisms such as Pre-Commercial Procurement (PCP) and Public Procurement of Innovation (PPI), ADD4KIDS offers a European Action Plan to overcoming these barriers. The project brings together a broad coalition of stakeholders—healthcare providers, policymakers, industry players, and patient advocates—to create an ecosystem where paediatric innovation can thrive. At the heart of this initiative is the belief that innovation is not just about developing new technologies—it is about ensuring that those technologies reach the children who need them. Hospitals do not lack innovative solutions; they lack the pathways to efficiently integrate them into everyday clinical practice. ADD4KIDS serves as the missing link, bridging the gap between promising medical advancements and real-world healthcare delivery. The European healthcare community has both the expertise and the responsibility to act. By fostering collaboration, aligning priorities, and embracing smarter procurement strategies, we can accelerate the adoption of life-changing innovations in paediatrics. This White Paper serves both as a reflection on the existing challenges as well as a call to action to rethink how we approach innovation in paediatric healthcare. Through ADD4KIDS, we have the opportunity to reshape the future of paediatric medicine. It is our collective responsibility to ensure that children across Europe receive the best possible care—not in the distant future, but starting today.
Dr. Joan X. Comella Director of Research, Innovation and Knowledge Management SJD Barcelona Children’s Hospital
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