- Africa is the world’s fastest-growing region, and the population could double by 2050, putting further strain on healthcare systems.
- The continent has made progress in controlling infectious diseases but faces the growing challenge of non-communicable conditions.
- Only 4% of clinical trials globally were hosted in African countries – this needs to change if the continent is to thrive.
Demographic trends define Africa as the world’s fastest-growing region, with its population potentially doubling by 2050. As the continent achieves significant progress in the control of infectious diseases, the rise of non-communicable conditions, in parallel with the possibility of emerging pandemic pathogens, is adding more pressure to already strained healthcare systems and posing challenges to continental development ambitions.
According to IQVIA, out of the 20,825 trials that started globally in 2023, only 819 – or 4% of the total – were hosted by African countries, which resulted in the continent providing less than 2% of genetic data analyzed in genomics research. Most of these trials were not only focused on infectious diseases but also restricted to phases III and IV (or phases focused on comparisons to current treatment standards and long-term effects), remaining consistent with clinical research trends over the last 15 years.
Figure 1 (below) illustrates these dynamics and the scenarios that Africa’s ambition could aspire to.
What if 10% of global clinical trials included African patients? Is this a possibility based on industry growth prospects, especially from the emerging biopharma sector, and what would the benefits be to patients, healthcare systems, and economies?
Click to enlargeFigure 1. Clinical trials in Africa versus the rest of the world. Source: IQVIA Global Site Management (2024).
While issues of genomic representation and pandemic preparedness are certainly critical for discoveries, why should we continue insisting on the need to increase investment in African clinical development?
The case for investing in clinical research in Africa
Clinical development has an overwhelmingly positive impact on patient populations in Africa, providing early access to cutting-edge treatments and immunization tools.
Similarly, producing therapies and vaccines that respond better to the genetic and phenotypic specificities of African populations can contribute to improved health outcomes for those living on the continent and the African diaspora migrating to other regions. Clinical trials are also a fundamental resource for global health security, assisting the swift development of vaccines in response to disease outbreaks.
Clinical research can develop or reinforce the medical infrastructure of host countries by increasing access to more global standards of care and directing clinical trial-related fees to hospitals and other sites. This attracts and retains researchers and sets the foundations for future studies. Increasing local research and home-grown innovation also gives way to cost-effective approaches to managing public health priorities, as domestic experiences can guide more targeted interventions.
The uses of trial-generated data can equally strengthen and harmonize regulatory frameworks, persuading life sciences companies to partake in regionalized manufacturing. If increased production can improve the availability of medicines and vaccines and make them more affordable, then additional investments in clinical research in Africa are pivotal to advance equity in access, create economies of scale, and support the inclusion of much-needed therapies in national health insurance schemes.
Studies show that every dollar invested in clinical research has a return of $405 in wider societal and economic gains, with product development in Africa, based on local trials, averting nearly 600 million disability-adjusted life years (DALY) between 2000 and 2022. For example, clinical studies to assess the treatment of schizophrenia with paliperidone palmitate in Rwanda were pivotal to catalysing research and development in other mental health areas, empowering local talent, strengthening local health systems, and adequately engaging patient communities.
Source: World Economic Forum
