Priority Medicines for Europe and the World 2013 Update. Background Paper 6 - Priority Diseases and Reasons for Inclusion. BP 6.23 - Neonatal Conditions
(2013; 50 pages)


The neonatal period is only the first 28 days of life and yet accounts for 40% of all deaths in children under-five. Globally, neonatal conditions accounted for 3 072 000 deaths in 2010 alone. Although the number of neonatal deaths has decreased since 1990, all regions have seen slower reductions in neonatal mortality compared to under-five mortality resulting in an increased share of neonatal deaths among total under-five deaths. In order to achieve the Millennium Development Goal 4 in reducing the under-five mortality rate by two-thirds by 2015, neonatal conditions need to be addressed immediately.

Among many neonatal conditions;

1) premature birth,

2) neonatal infections, and

3) birth asphyxia,

were identified as major contributors to the global burden of disease. Due to the complex etiology of these conditions, preventive methods, diagnostic tools, and treatments remain limited. Many of the current preventive approaches focus on maternal health prior to the newborn’s arrival such as maternal immunization and ensuring a healthy pregnancy. Several treatments exist for neonatal conditions that may reduce the risk of maternal and neonatal mortality. However, these treatments are still not ideal in formulation, packaging, and/or accessibility. For example, several tocolytics are available to inhibit preterm labor, but are often accompanied by adverse side effects to both the mother and newborn. The current formulation and packaging for the recommended antibiotics to treat neonatal sepsis are not readily available and require properly trained care providers to administer them. Surfactant preparations are effective in treatment of newborns with respiratory distress syndrome, but are expensive to produce and are limited. Furthermore, lack of rapid diagnostics often leads to non-judicial use of antibiotics that may contribute to the rising concern for antimicrobial resistance. These are only several challenges that currently exist in addressing neonatal conditions.

Despite the large global burden from neonatal conditions, investment in research funding for neonatal survival is extremely low. It is estimated that only around US$ 20 million per year is invested into research for neonatal survival. A recent global analysis suggests that newborn survival will remain vulnerable on the global agenda without adequate funding and without high-level engagement of policy-makers. For this reason it becomes imperative that more funding and long-term support from the European Commission be allocated towards research and development addressing neonatal conditions.

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