Paediatric care differs throughout Europe (1-6). This is a vital issue for the very sick children with life-threatening diseases of heart, liver, lungs or kidneys being in need of high-end care or even transplantation. Actually, life expectancy of children with such organ diseases depends on birthplace, an infant with severe heart disease or kidney failure may have a likelihood of more than 90% to reach school age in any given old member state (MS) but of less than 10% in some other European and Western Balkan countries. For stakeholders involved this status quo is not acceptable: Parents are desperate about those inequalities. A small minority of them is capable of organizing costly cross-border health care with E 112 in an old MS, but will then encounter limitations of local after-care. Doctors, nurses and health care providers are sometimes not able to provide even minimal standard care-compared to old MS benchmarks?and need partners in old MS and European-wide networks. Other stakeholders as health authorities, representatives from insurances and policy makers-albeit recognizing the human tragedies-have to face economic restraints. Industry who is gaining new markets might be interested to invest into the future of those very sick children. NGOs can help with focused actions but have limited means.