Why Inclusion is Key: Enhancing Clinical Research Participation in Africa

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While the rest of the world advances in healthcare, Africa faces significant challenges in keeping pace. Despite being the second most populous continent with over 1.2 billion people, Africa accounts for only 5% of global clinical trial enrollment, according to the African Clinical Research Association (ACRA). The continent’s diverse population, ethnicities, and socio-economic conditions offer a rich genetic pool for clinical trials, raising the question of why more sponsors are not taking advantage of this opportunity.

Generally, without clinical trials, medical advancements are impossible. For Africa, a continent with a vast population, the absence of healthcare improvements would be catastrophic, resulting in increased mortality rates. The World Health Organization (WHO) reports that Africa carries the world’s highest disease burden at approximately 25%, including severe illnesses such as HIV/AIDS, malaria, tuberculosis, acute respiratory infections, and diarrheal diseases, all of which have high mortality rates.

Understanding how genes and environmental factors contribute to disease enables earlier diagnoses, interventions, and effective treatments, thereby enhancing healthcare. It is crucial to test medical interventions across diverse populations, as different groups may respond differently due to variations in disease prevalence, genetic makeup, and other determinants. Yet, most genomic data used in research is derived from Europe, the United Kingdom, and North America. Despite Africa’s significant role in human evolution and its vast, genetically diverse population, it remains underrepresented in genetic studies. This lack of representation not only limits healthcare advancements in Africa but also restricts global medical research. Considering the genetic differences between African populations and others, it is vital to include African genomic data to achieve comprehensive and effective healthcare solutions worldwide.

The pharmaceutical industry’s leaders are increasingly acknowledging the importance of diversity and inclusion, with some committing to expand their presence in Africa. Despite this positive development, there remains a scarcity of sponsors willing to invest in the continent. This reluctance stems from challenges in translating research findings into clinical practice, increased by poor infrastructure, inadequate healthcare resources, and limited research funding. This underscores the urgent need for African governments to enhance their efforts, focusing on refining regulatory policies and raising awareness about the opportunities and challenges associated with clinical trials.

In Africa, participant recruitment has primarily depended on referrals from healthcare providers and some community outreach efforts by non-profit organizations. According to the Center for Information and Study on Clinical Research Participation (CISCRP), although 64% of the public learns about clinical research from their primary care providers, the recruitment rate remains at a mere 0.2%. While these traditional methods have been somewhat effective, they face significant limitations in today’s landscape.

However, the advent of digital marketing and the potential involvement of government agencies offer promising alternatives. These avenues hold the potential for more effectively targeting specific participant populations in clinical trial recruitment efforts.

References

Adam, J. (2024, June 13). From AI to telemedicine: Transforming clinical trial recruitment in 2024. Labiotech.eu. https://www.labiotech.eu/expert-advice/clinical-trial-recruitment/

African Clinical Research Association (ACRA). (2024, May 20). ACRA report International Clinical Trials Day. Www.linkedin.com. https://www.linkedin.com/feed/update/urn:li:activity:7198239496591593473/

Love, A. (2023, March 20). Africa: Unleashing the potential of the new superpower in clinical trials. Pharmaceutical Technology; Pharmaceutical Technology. https://www.pharmaceutical-technology.com/sponsored/africa-unleashing-the-potential-of-the-new-superpower-in-clinical-trials/

Philpott, J. (2024, March 7). Clinical trials in Africa: Where there is a challenge, there is an opportunity. Clinical Trials Arena. https://www.clinicaltrialsarena.com/news/clinical-trials-in-africa-where-there-is-a-challenge-there-is-an-opportunity/?cf-view

Saleh, M., Sharma, K., Shamshudin, A., Obayo, I., Gondi, S., & Karimi, N. (2024). Regulatory approval of clinical trials: is it time to reinvent the wheel? BMJ Global Health, 9(1), e013727. https://doi.org/10.1136/bmjgh-2023-013727

Taylor-Robinson, S. D., Spearman, C. W., & Suliman, A. A. A. (2021). Why is there a paucity of clinical trials in Africa? QJM: An International Journal of Medicine, 114(6), 357–358. https://doi.org/10.1093/qjmed/hcab010

World Economic Forum. (2022, May 21). Clinical development will meet Africa’s unique health needs. World Economic Forum. https://www.weforum.org/agenda/2022/05/how-clinical-development-can-meet-africas-unique-health-needs/

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