The limited ability to rescue HICP, while under fire or into a hazardous environment, is itself a major cause of poor outcome and death.

In the CBRN contaminated battlefield, combat-related injuries are “combined” – related to both, trauma and contamination. The time to aid a victim is crucial. This is even true for combination injuries. Hence there is a need to provide solutions for autonomous battlefield triage, safely extraction of HICP from the battlefield, providing instant availability information about vital signs, rapidly diagnosing life-threatening injuries, remote access of medical personnel to the casualty and delivering life-saving interventions. Extraction robots and dedicated evacuation vehicles may decrease the risk to the soldier and combat medic by life-saving robotic-assisted interventions, and by safely moving wounded soldiers out of the line of fire. Tele operated and autonomous surgical robots may deliver expert surgical care within the “golden hour” on the battlefield as well as during transport to military treatment facilities. In CBRN situations, notably under radiation exposure, further restrictions have to be dealt with such as limited accessibility of the affected areas and concerns regarding the safety of the rescuing personnel.

Proposals must address extraction, treatment, and evacuation systems, including detection, diagnostics, integrated life-support systems and transport of HICP. Proposals must in particular address:

• design of a dedicated CBRN casualty extraction device and/or adaptation and integration of existing capabilities, ‘porter’ or load- carrying UV/RGP1 capable to locate, lift (scoop) and rescue, operating in hazardous and uneven/rough conditions,
• patient on-board life support and containment system supported by automated recording of vital signs to perform preliminary diagnostics and movement of casualties, containing ventilator, defibrillator, in-/out protection, and devices to monitor the physiological status of the patient to perform preliminary diagnostics,
• decontamination technologies for safe treatment and/or transport of HICP,
• robotics-assisted life-saving intervention, such as automated administration of anti- dots and/or haemostats or tourniquets,
• solutions for quick location of casualties and initial diagnosis, including triage, in case of CBRN events, for example based on wearable (bio)sensors or other sensor solutions.

In addition, proposals should also address:

• methods and concepts for seamless interoperability and complementarity of CBRN casualty extraction devices, whereas casualties could be evacuated by unmanned vehicles and robotic platforms and transported to medical treatment facilities,
• compatibility between transport types with plug & transport solutions leading to an enhanced responsiveness and resilience. E.g., by a modular platform system as a basis for multiple (unmanned) aerial or ground vehicles: (roll-on / roll-off platform system),
• integration of CBRN casualty extraction devices into health monitoring platforms and/or CBRN DIM2 systems,
• harmonization of the different concepts of operation (interoperability) fostering the collaboration of EU Member States and associated countries with a standardized solution,
• investigation of new possibilities to transport and assist HICP,
• semi-autonomous or ‘supervised’ surgical capabilities, concepts for material, structure design, ventilation and medical supply logistics for the safe transport and assistance (including treatment) of contaminated or contagious casualties in CBRN hazard area,
• evaluate the designated materials, the components and the final system during transport and assistance of contaminated/contagious casualties,
• selection of material and components, and evaluation according to suitable simulation and testing procedures.

1 Unmanned vehicle/Robotic ground platform

2 Detection, identification, monitoring

The proposals must substantiate synergies and complementarity with foreseen, ongoing or completed activities in the field of MEDEVAC³ and RSS⁴, notably those performed or foreseen in the context of EDIDP, EDF 2021, Horizon 2020 and Horizon Europe.

Functional requirements

The proposed activities should address technologies to provide the following functional requirements:

• adaptable UxV evacuation vehicle and/or platforms for different operations (for example short/medium/long range transport of HCIP);
• air filtration system with air quality monitoring capability to be applied during transport, which would be adaptable for different CBRN conditions – HICP with different agents;
• option for transport of casualty/patient required ICU⁵;
• integrated decontamination system/capabilities;
• operate in extreme environments (including hazardous environments) and provide combat casualty care as close as possible to the point and time of injury;
• robust, light and small as possible, resisting fog, mud or dust and extreme temperatures, in order to assure a correct service in hostile environments and over debris surfaces;
• track, record, transmit and act upon continuous near-real-time measurement of physiological/health data rendered by wearable biosensors;
• locate and evacuate HICP from the battlefield using UxV evacuation platforms;
• carry / integrate a payload of medical supplies including a life support and surgical system capable to perform automated and/or robotic assisted lifesaving interventions, e.g., administer CBRN medical countermeasures using a robotic arm;
• (semi-) autonomous deployable surgical platform, including miniaturized surgical devices for robotic surgery to fit in casualty extraction UxV;
• integration of diagnostic, imaging and therapeutic capabilities (e.g., digital x-ray, portable ultrasound, intubation);
• smart textile sensor integration and wearable biosensors;
• carry / integrate into CBRN DIM system to provide early information as to the possible toxic hazards in the environment;
• remote assistance, including tele-medicine, such as technologies to communicate with a reach-back human medical team, imaging technologies and/or augmented reality technologies;
• protect the HICP during transport;
• for design of platforms, a manual with all tested and evaluated procedures should be

Expected impact

• Provide substantial improvements to the CBRN / medical defence domain for Member States and Norway armed forces that can revolutionize battlefield care by safely extracting casualties and patients from harm’s way, rapidly diagnosing life-threatening injuries, delivering life-saving interventions and ensuring their safe transport (short- medium or long range) to dedicated medical facilities;
• Facilitate the development of CBRN / medical defence capabilities that each Member State, associated country, individual government or industry cannot face alone;
• Strengthen European sovereignty and contribute to the EU strategic autonomy;
• Develop EU autonomous industrial

³ Medical evacuation

⁴ Reconnaissance and surveillance services

⁵ Intensive care unit

Unlike other fields of defence research and development, medical threats are changing rapidly and require continuously new methods of diagnoses, assessment and treatment. Defence medical countermeasures (MCMs) must be kept up-to-date, available and able to respond to the continuously changing and novel health threats posed by CBRN. To master the evolving threats, the Commission intends to establish a stable and structured partnership with legal entities grouped in a consortium which commit themselves to:

• Create a long-term open, supportive and sustainable cooperation mechanism in Europe amplifying, connecting and strengthening EU (defence) medical research and development capabilities on selected medical threats; and,
• Contribute to the accessibility and availability of medical countermeasures and strengthen their disposability.

This partnership will enable the implementation of a multi-annual planning (roadmap) of research and development activities. The FPA will set out the framework conditions governing the award of grants to beneficiaries on the basis of the roadmap, specify the objectives, the nature of the actions planned, and the procedure for awarding specific grants.

The Commission envisages to dedicate up to EUR 100 000 000 during the four years of execution of this FPA. The budget and rules on funding will be set out in each SGA and depend on the specific type of proposed actions. Beneficiaries will be identified after the evaluation of the applications submitted in response to the FPA call. In a subsequent step, these selected beneficiaries may be invited to submit their proposals for the award of SGAs. Framework partnership agreements do not give the partners (i.e., FPA beneficiaries) any right to be awarded specific grants.

Activities eligible for research or development actions to respond medical countermeasures. These activities entail a large scope covering, among others, innovation, research, design, testing and analysis.

The activities subject of the FPA are expected to contribute to the following outcomes:

• Establish a technology innovation roadmap (multiannual action plan) for linking early-stage capabilities to industry developments.
• Focus on research, innovation and development of defence medical countermeasures against CBRN threats as well as their integration into MS military forces, EU and MS health sector and civil protection mechanisms.
• Establish a well-connected network at European level in order to facilitate interoperability in detecting and validating CBRN threats and enlarge capabilities by a consequent cooperation and subsequent division of labour and capacities.
• Stimulate cooperation between European military and civilian research institutes and industry to initiate a core of European research base on military health issues.