Why is there a paucity of clinical trials in Africa? COMMENT

Disproportionately few clinical trials are undertaken on the African continent, in part due to lingering neocolonial attitudes in the Global North which keep research activity primarily in developing countries, while being skeptical of the abilities of those in the Global South to undertake organized clinical studies. In the era of the COVID-19 pandemic, applicable research and clinical trials should be undertaken in relevant populations in order to extrapolate to a population level. This is all the more important in Africa, which has a rich genetic diversity. We suggest that a lack of organized research ethics committees across the continent and a deficiency of appropriate training are responsible in part for the reluctance of clinical trial organizers in the developed countries of the Global North to engage with medical leadership in Africa. We consider ways of alleviating this problem, including suggesting a pan-continental surveillance of ethics committee agendas and of training, either through the auspices of the African Union or the World Health Organization. In addition, medical leadership in African nations must be encouraged to take ownership of their medical ethics agendas to facilitate decent international clinical trial participation for the good of the continent as a whole.

Automated summary

Due to neocolonial attitudes and lack of research ethics committees, there are disproportionately fewer clinical trials conducted in the Global South. In the era of the COVID-19 pandemic, more relevant population research and clinical trials should be conducted in Africa to extrapolate to a population level. Medical leadership in African nations should take ownership of their medical ethics agendas to facilitate international clinical trial participation for the continent as a whole.