Why Expanding Clinical Trials in Africa is Key to Global Health and Access to Innovative Medicines

Illustrative Image: Why Expanding Clinical Trials in Africa is Key to Global Health and Access to Innovative Medicines
Image Source & Credit: The World Economic Forum
Ownership and Usage Policy

Africa carries a staggering 25% of the global disease burden, yet the continent hosted only 1.1% of global clinical trials in 2023, according to the World Health Organization (WHO). This significant underrepresentation not only limits access to life-saving treatments for millions of Africans but also weakens the global health security landscape.

Why Clinical Trials Matter

Clinical trials are more than a mechanism for developing new therapies — they are a gateway to healthcare access. They determine:

• Where and how quickly new drugs and therapies are approved,

• Whether treatments are tested for safety and efficacy across diverse populations, and

• Which countries receive first access to the latest healthcare innovations.

If Africa is excluded from these studies, the continent not only loses out on immediate access to innovation but also lacks the evidence base needed for localized medical guidelines and regulatory decisions. This ultimately slows the availability of effective therapies in African markets and impedes efforts to strengthen healthcare systems on the continent.

A Narrow R&D Focus Leaves Africa Behind

The 2024 Access to Medicine Index highlights a major gap: only 27.5% of late-stage R&D projects from 20 major pharmaceutical companies included at least one African country. Furthermore, of 80 medicines being developed for priority diseases, only 16 are being tested in Africa, despite the continent bearing the brunt of many of these illnesses.

This gap is especially troubling in areas like sickle cell disease, which disproportionately affects African populations (over 80% of global cases occur in Africa). Despite promising breakthroughs like gene therapy, not a single clinical trial for these advanced treatments is currently underway in Africa. Similarly, long-acting injectables, which improve treatment adherence, remain largely trialed in Africa only for HIV/AIDS, neglecting other chronic or non-communicable diseases (NCDs).

The Broader Implications for Global Health

Africa’s exclusion from the clinical research ecosystem is not just a regional concern — it has global consequences. Diseases don’t respect borders, and inclusive research improves preparedness and resilience worldwide. Moreover, failure to involve African populations in trials leads to treatments that may not work as effectively due to genetic, environmental, or sociocultural differences.

Promising Progress: Infrastructure and Innovation

Despite these challenges, Africa is making strides. Investments in clinical trial infrastructure for infectious diseases have established a robust foundation, thanks to collaborations with:

• The Africa Centres for Disease Control and Prevention (Africa CDC)

• The European and Developing Countries Clinical Trials Partnership (EDCTP)

• WHO-TDR (Special Programme for Research and Training in Tropical Diseases)

• Regional Centres of Regulatory Excellence (RCOREs)

These institutions have:

• Trained hundreds of local researchers and healthcare professionals,

• Set up networks like the Africa Clinical Research Network, and

• Enabled significant trials like IMPALA, which evaluates long-acting HIV treatments across multiple African sites.

Furthermore, Africa is undergoing a regulatory transformation. The upcoming African Medicines Agency (AMA) promises to accelerate drug approval timelines and harmonize regulatory processes across the continent. This can substantially boost local access to innovative treatments and strengthen Africa’s participation in global health governance.

What Needs to Change: Industry Engagement and Investment

While infrastructure and policy are improving, the pharmaceutical industry must take responsibility. Inclusive trial design is possible — some companies have already demonstrated early access strategies and local data collection. However, these examples remain rare.

To correct this imbalance:

• Pharmaceutical companies must expand their clinical trial footprint in Africa beyond infectious diseases to encompass NCDs such as cancer, diabetes, and cardiovascular conditions.

• Investors and global health donors must support African-led initiatives, ensuring financial and technical backing.

• Governments and health ministries across Africa must advocate for inclusion in multinational trials and build strong ethical and scientific review boards.

The Way Forward: Partnering for Impact

Organizations such as the Africa Clinical Research Network stand ready to connect global sponsors with qualified African trial sites, doctors, and institutions. However, unlocking this potential requires more than partnerships—it demands commitment, investment, and trust.

By putting African people and institutions at the center of the clinical research process, we can design medicines for their specific needs, improve health equity, and create a research ecosystem that benefits everyone, everywhere.

Conclusion

Inclusion in clinical trials is not a luxury — it is a necessity for equitable healthcare. Africa is ready with growing infrastructure, regulatory reform, and skilled personnel. What remains is for the pharmaceutical industry, policymakers, and investors to act decisively. Integrating African countries into global research from the outset is essential to ensure timely access to medicines, enhance global health security, and build resilient health systems for the future.