People from different groups need to take part in clinical research and trials. This is how we show that medicines work and are safe enough for their intended groups. Without balanced representation, including demographics, access to healthcare, and standards of care, it can be challenging for the pharmaceutical and healthcare industries to completely understand how diseases progress and how likely drugs will work in different groups. This is especially important in historically under-represented and understudied populations.

Importance Of Clinical Research In Africa

So far, not much clinical research is known in Africa. One estimate says that only 2.5% of clinical trials occur on the continent, even though 17.5% of people live there. Most of these trials happen in South Africa or Egypt, while many other countries barely do any research.This isn’t good for the people who pay for clinical trials and the people in Africa. From the sponsors’ point of view, they are missing a chance to do cheap research with a wide range of patients, including many who have never been treated for their illnesses before.

From the point of view of regular people, there might not be enough good medicines if there isn’t enough clinical research. We know that some diseases are more common in some ethnic groups and that a person’s genes can significantly affect how well they respond to treatment. You can’t always extrapolate results from Seattle to Senegal and think they will work there.

Previous research has shown that cancers in people of African descent are genetically different from those of Caucasian descent.

This means that there are differences in the number of people who get certain cancers, the age at which they are diagnosed, and the possible outcomes, which are not always linked to access to care. Any intervention needs to be tested on people of different races.

Also, it should be evident that research on infectious diseases should be done in places where they are shared. Before Covid-19, sub-Saharan Africa had to deal with as many as 50% of the infectious diseases in the world. Why do we have to do clinical tests in Africa?

Africa has a lot of the best places to do clinical trials. Many people from different ethnic groups could be patients on the continent. Many of them have never been given medicine for their illnesses. Researchers might be able to get helpful information from the mainland.

Why Don’t There Seem To Be Many Clinical Tests In Africa?

Clinical trials aren’t done as much as they should be on the African continent. This is because some people in the Global North still have neocolonial ideas, which keeps most research from happening in the Global South, and they aren’t sure if people in the Global South can do organized clinical studies.

Why Are Clinical Trials Still Done In Developing Countries?

In developing countries, there are a lot of infectious (like HIV/AIDS, tuberculosis, and malaria) and non-communicable (like diabetes) diseases. Clinical trials are needed to find new, effective ways to diagnose and treat these diseases.

Pay Attention To A Case In Malawi

The Malawi-Liverpool Wellcome Clinical Research Programme’s senior pediatrician, Dr. Pui-Ying Iroh Tam, recently helped set up a trial in Malawi. This was a Phase IIA test of clofazimine, a drug that helps HIV patients with diarrhea caused by cryptosporidium.

In a 2020 paper, the team led by Iroh Tam said it wasn’t easy to get the trial up and to run. These had to do with how the study was started, with the people who took part in it, and with cultural factors.

By focusing on regulatory and operational barriers, we solved these problems. It allowed the scientists to conduct rigorous experiments with intricate endpoints. Our findings from these studies may be used for future clinical tests in Africa.
When she thinks about Africa, she feels that infrastructure is a big problem, both from a regulatory and a supply side. A recent report said that only seven of the 5,349 medical labs in Nigeria met international standards.

The African Academy of Sciences and other groups have worked to improve the regulatory infrastructure. Still, Iroh Tam points out that Africa is made up of 54 countries that all do things differently and have different capacity levels. Getting the tools and materials researchers to need to the site is hard when supply chains aren’t set up well.

Also, many sites have trouble building their capacity, especially when putting together the right research team. Researchers should be able to come up with and run clinical trials independently and have enough training to make sure the problems are solved well. Iroh Tam thinks this is the job of local and international funders and sponsors.

Funders and sponsors need to realize that high-quality clinical trials can be done in Africa with little money. This continent is a good place for clinical research that could make a big difference in health and disease because there are so many diseases and conditions here.

How To Move On From Diseases?

Even though infectious diseases may get more attention, non-communicable diseases are also a big problem on the continent. Cancer kills more Africans than malaria, and diseases like type 2 diabetes and heart disease worsen.

Unfortunately, there aren’t that many cancer studies on the continent and many of the ones that do happen focus on diseases like cervical cancer that are linked to an infectious agent. They are also often started by people or groups outside the site working with it. Jennifer Dent, president and CEO of Bio Ventures Of Global health, says that international pharmaceutical companies need to come to Africa and start to fill in the missing cancer data.

A business must figure out how to do clinical trials in African countries.” When about 40% of the patients can’t be found, it can be hard to figure out how to run an excellent clinical trial. But in the end, it’s the right thing to do.

She says that international companies tend to go back to the same sites over and over because they know they are reliable and don’t want to take a chance elsewhere. These sites have all the people, equipment, and systems they need to run a clinical trial correctly. Companies and schools need to spend money to help African centers get better at doing this.

Some people have trouble paying for transportation to the clinical site, which makes it hard to get and keep people in clinical studies. She hopes that people will start to find new answers after the pandemic.

Even in the U.S., companies are thinking about how to run clinical trials differently and reach a broader range of patients.

Building A Start

Bio Ventures Of Global Health started the African Consortium for Clinical Trials to help build trial capacity. With the help of business and academic partners, the team has made a tool to measure how “ready” African cancer hospitals are for clinical trials.

According to Graef, we are utilizing them to demonstrate everything from the efficiency of their laboratories and support workers to the effectiveness with which their leaders are overseen. There is more than one reason for making these profiles. First, they can be used by outside groups to find new places to do clinical trials. Bio Ventures Of Global health hopes that they will help Western and African oncologists build stronger relationships with each other.

Second, Bio Ventures Of Global Health can use them to find where there is the most miniature training for cancer clinical trials in Africa. Together with its partners, the group runs different training programs and gives small grants to researchers at the beginning of their careers.

Long-term, Graef and Dent want the NIH or other large funding groups to give more money to clinical trials in Africa. They also want more studies to be started by local researchers instead of groups from outside the area.

For more grassroots clinical trials to happen, there also needs to be more money and a change in how people think.” “It’s important to remember that we can’t just do one study, leave the site, and expect the trained staff to stay. We must ensure the site is used frequently so they can use their skills.”

Things are improving in this area, even though clinical research on the African continent is still not where it needs to be. The Covid-19 pandemic showed that health is a problem for the whole world, not just one country. Clinical trials in Africa will be an essential piece of the puzzle we need to solve.

Final Words
A lack of representation can also cause a lack of trust in the healthcare and pharmaceutical industries. During the COVID-19 pandemic, we saw what happened when people didn’t trust vaccines. In the U.K., data from the Office of National Statistics show vaccine hesitancy has decreased over time, but rates are still much higher in some marginalized groups.

It is also essential to look for better ways to gather evidence from pregnant women and mothers who are breastfeeding, as this is a big but underserved group. We hope that if more people participate in clinical trials, we can improve everyone’s health and well-being.

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James Lind Institute offers a number of online clinical research programs and courses that researchers from Africa can benefit from.