Ensuring preparedness for emerging infectious diseases involves more than just emergency response; it requires consistent research systems to quickly generate and share new knowledge globally. This is the mission of the European Clinical Research Alliance on Infectious Diseases (Ecraid), a pan-European, non-profit network aiming to enhance Europe’s study and response to infectious diseases, including antimicrobial resistance and other health threats.
Dr. Lennie Derde, an intensive care physician and infectious disease researcher with pandemic-scale research experience, became Ecraid’s CEO in January 2026. Previously, she led the European segment of the REMAP-CAP trial, critical in identifying effective COVID-19 treatments.
Dr. Derde emphasizes the importance of “everyday preparedness,” EU investments that made Ecraid possible, and the necessity of multinational collaboration in tackling borderless threats.
Why Europe Needs a Permanent Clinical Research Network
The past two decades have highlighted the necessity for change in pandemic research. From the 2009 H1N1 pandemic to COVID-19, it’s clear how swiftly diseases spread and how ill-equipped research systems can be.
“In a pandemic, you cannot start building a network from scratch. You need hospitals that are already engaged, trained, and resourced, ready to begin research immediately,” says Dr. Derde.
During H1N1, few patients joined clinical trials, and none provided results during the pandemic. In contrast, COVID-19 trials generated faster evidence due to pre-existing systems. Thus, a permanent Europe-wide network is vital. Ecraid has developed this infrastructure over years, maintaining a “warm-base” research network, where sites are continually engaged in studies and ready to respond during emergencies.
Link Between Antimicrobial Resistance and Pandemic Preparedness
Ecraid, committed to mitigating infectious diseases’ impact, addresses two main challenges: the rise of fast-spreading new diseases and increasing antimicrobial resistance.
New diseases emerge more frequently due to climate change, increased travel, and closer human-animal contact. Concurrently, bacterial resistance to antibiotics, termed the “silent pandemic,” affects everyone needing infection treatment.
Ecraid’s Europe-wide network of researchers and hospitals, collaborating with European and global partners, provides the expertise and capacity for coordinated threat response.
EU Funding’s Role in Ecraid’s Development
EU funding was pivotal in transforming Ecraid from a concept to a functioning network. The EU’s foresight played a crucial role.
Ecraid’s inception stemmed from two EU-funded projects: COMBACTE, focused on antimicrobial resistance, and PREPARE, addressing emerging diseases. These aimed for long-term sustainability, evolving into ECRAID-Plan, a Horizon 2020 initiative laying Ecraid’s foundation. In 2021, a €30 million EU investment in ECRAID-Base enabled the establishment of the network, large studies, and continued trials.
This funding has allowed Ecraid to become a self-sustaining organization through public and industry partnerships, showcasing the EU’s capacity to create lasting public health value.
Advancing Research with Continuous Studies and Adaptive Trials
Adaptive platform trials enhance speed and flexibility in clinical research. Instead of single-treatment testing, they investigate multiple therapies in one trial, allowing each participant to contribute to multiple queries.
New treatments can be added as trials progress, similar to adding carriages to a moving train, enabling immediate testing without delay. Advanced statistical methods in these trials offer flexibility amid uncertainties, generating results faster than traditional methods.
International Collaboration Lessons from REMAP-CAP During COVID-19
Leading the European segment of REMAP-CAP during COVID-19, Dr. Derde learned the strength of international collaboration. Global data and workload sharing accelerated results far beyond isolated efforts.
This experience underscores the importance of Ecraid’s connections with global research networks. Infectious diseases and resistance transcend borders, necessitating cross-country cooperation for effective research.
Defining “Everyday Preparedness”
Being research-ready combines cutting-edge science and practical quick-response capabilities. It’s about having systems ready to operate in real hospitals with actual patients, beyond just ideas.
Ecraid’s data-driven network identifies each site’s strengths, tracking disease impact through ongoing studies and large trials that swiftly adapt to new threats.
Ensuring data fluidity across healthcare—from clinics to intensive care units—facilitates faster collaboration and improves patient care.
Ecraid’s Future Direction
Health research evolves with scientific and global changes. Ecraid remains adaptable, contributing to initiatives like the European Partnership for Pandemic Preparedness and the BE READY NOW initiative, fostering an interconnected “network of networks.”
Continuing challenges like drug resistance and zoonotic diseases persist, affecting health globally. Ecraid addresses these risks through cross-border, interdisciplinary efforts, employing innovative research for enhanced prevention, treatment, and preparedness.
The interviewee’s views do not necessarily reflect those of the European Commission.
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