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We welcome the report of the Lancet Child and Adolescent Health Commission on the Future of Neonatology with contributions from a broad range of stakeholders including clinicians, parent and patient groups, and representatives from regulatory and other bodies from around the world. 1 We write as UK authors of the report of the Commission. We are glad to have the opportunity to raise awareness of the important issue of optimising and safeguarding newborn health, and to highlight and expand on some of the points made by the Commission. Improving newborn health is a moral imperative, not least because we are living in a period of uncertainty, with war zones affecting even basic neonatal care, but also because trajectories of health and disease are established in early development. A substantial proportion of the population has their future life-long health disrupted by processes operating in early development.2 Hence, if the lasting damage poor newborn health is inflicting on individuals and societies is to be curbed, identification of the biological mechanisms that define these pathways should be cardinal scientific and political goals. The early determinants of diseases encompass physical and mental health, but curiosity, innovation, resilience, cognition and higher executive functions, positive attributes that enhance human potential and offer a gateway to a better future, also have their roots in early life.3 4 Newborn health is therefore also the route to improved population mental and physical well-being, and a pathway to sustainable economic resilience.