Meet the team behind c4c!


We are a diverse group of people from many different backgrounds, but all of us are working towards a common goal: better medicines for children through European clinical trials.


Today’s spotlight is on Ricardo Fernandes, from the University of Lisbon and AIDFM.



Ricardo is a well-established physician, academic and researcher: a consultant paediatrician, a paediatric allergist, with a PhD in clinical research, and is a professor in clinical pharmacology. For the last several years he has been passionate about developing and improving medication options for children. His research began in Portugal over 15 years ago, focusing on the placebo arms of clinical trials. Alongside groups in the Netherlands and Canada, he has been involved in developing new methods for the design, reporting and synthesis of clinical trials for children. To support the advancement and evolution of medical research in children, Ricardo has also been involved with several clinical research networks, including the StaR Child Health Initiative, the European Respiratory Society, the global Pediatric Emergency Research Networks, and the Cochrane Collaboration.

Paediatric clinical trials in Portugal

So why focus on improving clinical research in Portugal? Well historically, Portuguese medical centres are often overlooked for clinical trials as Portugal is one of the smaller countries in Europe.

But paediatric trials are a special challenge, and Ricardo estimates that only around 5-10% of the country’s clinical trials per year are focused on children. The reasoning is primarily a gap in resources needed. There are not enough medical staff to dedicate to paediatric studies, nor trained staff to run them – more medical doctors, research nurses, and study coordinators are needed. And there is a lack of infrastructure in the country’s hospitals. Ricardo explains, “it’s always hard to sell the inclusion of children in the business case, on top of the scientific and ethical cases for clinical trials, because research teams receive limited funding.” Changes in the public health system and pressure from the pandemic have not helped to ease the situation.

But interest is not an issue – healthcare professionals already working in clinics want to get more involved. “It’s hard to have a core of paediatric-focused research staff and a community to support that research, as paediatrics is often an afterthought, even in academic centres. But I think there are people that are very willing, there are people that are competent, and there is a paediatric community that delivers quite good quality of care and that is interested in exploring and delivering research opportunities to their patients and families.


Ricardo’s activities with conect4children

Ricardo wanted to use his extensive experience to further develop Portugal’s paediatric clinical trial and medicine landscape, so in 2017 he reached out to the c4c consortium that was being established. Not long after, he and the soon-to-be-developed STAND4KIDS team were accepted into the network. The first years were spent understanding the project, developing it, and moulding it into a workable process. Using what he learned through his involvement with c4c, Ricardo created and now leads STAND4KIDS, a paediatric trial network and Portugal’s National Hub for c4c studies.

Because of the number of challenges involved in paediatric clinical trial work, as well as their importance, Ricardo gradually reduced his clinical and academic work to focus more on c4c activities. After identifying the need for the 20 National Hubs to better share their knowledge and experience, Ricardo and Régis Hankard from France’s PEDSTART, created c4c’s National Hub Forum in 2019 and they continue to act as its coordinators. Ricardo is currently co-lead for c4c’s work package 7, involving the implementation and testing of processes and tools to run clinical trials, and part of c4c’s Network Infrastructure Office. He is actively involved in the transition to the new legal entity conect4children-Stichting, as a Chief Medical Officer.

While there is still a lot of progress to make, the contributions of physicians like Ricardo are helping to move things forward. His dedication to children’s medicine has had a big impact not only in Portugal but for European trials overall, with more opportunities for paediatric clinical trials becoming available in the past few years. The future is looking positive. As Ricardo summarises, “It’s been great to watch things grow, even in directions where maybe I wasn’t anticipating.