WHO Report Challenges Adult-First Approach to Clinical Research for Children Under 10

The World Health Organization has questioned the long-standing practice of starting clinical research with adults before extending findings to children. A major new report released on 6 November 2025 calls for a fundamental shift in how medical research approaches child health.

The Problem with Trickle-Down Medicine

Most clinical research begins with adult populations. The resulting changes to practice and policy then filter down to children – often years later.

But this approach leaves significant gaps in evidence for treating children aged 0-9 years. The WHO’s technical report ‘The future of paediatric clinical trials – setting research priorities for child health’ identifies 172 priority clinical research questions that need urgent attention.

What the Numbers Show

Over 380 people affected contributed 653 research questions to the WHO process. These were refined down to 172 key priorities across infectious diseases, noncommunicable diseases, newborn health, early childhood development and nutrition.

Children remain heavily under-represented in clinical trials. This creates evidence gaps that directly affect policies, guidelines and programmes for child health – chiefly in low- and middle-income countries.

Despite significant reductions in under-five mortality over the past two decades, progress has now stalled. Preventable illnesses continue causing sizeable child illness and death.

A Call for Change

Dr Meg Doherty, Director of WHO’s Department of Science for Health, said the agenda provides clear direction for investment to coordinate resources and address the highest-burden child health areas.

The report follows WHO’s 2024 guidance calling for greater inclusion of under-represented populations in clinical trials. Newborns and infants are especially under-represented in current research.

Research advocates argue children should be protected through research, not from it. Rising chronic diseases like obesity and asthma make this work increasingly urgent.

Key Takeaways

• WHO identifies 172 priority research questions for children aged 0-9 years
• Current adult-first approach to clinical trials leaves dangerous evidence gaps
• Over 380 global interested parties contributed to developing the new research agenda

What This Means for Kent Residents

Kent families with young children may face delays in accessing the most effective treatments due to this research gap. NHS Kent and Medway Integrated Care Board oversees local child health services, but under-representation in trials could mean Kent children with conditions like infectious diseases or nutrition issues don’t receive optimal care. Parents seeking access to paediatric clinical trials should contact regional centres like Evelina London Children’s Hospital or Great Ormond Street Hospital, as no Kent-specific paediatric trial hubs have been identified.