Strengthening Africa’s clinical trial ecosystem through equity and collaboration

A stimulating debate on Thursday afternoon highlighted multiple ways in which stronger and more equitable partnerships could help to build a more resilient and productive clinical trial ecosystem in Africa.

The limited number of clinical trials taking place in Africa was highlighted multiple times during the Forum. At a parallel session, introduced by Caxton Murira (Science for Africa Foundation, Kenya), representatives from funders and other agencies discussed some of the ways in which the clinical trial ecosystem in Africa could be strengthened to address this imbalance.

After introductory presentations from Alethea Cope (Wellcome Trust, UK) and Evelyn Gitau (Science for Africa Foundation, Kenya), much of the session was devoted to a panel discussion, chaired by Shingai Machingaidze (CEPI), featuring: 

  • Lillian N Mutengu, Science for Africa Foundation, Kenya
  • Lindsay Keir, Impact Global Health, UK
  • Michelle Nderu, EDCTP Association, South Africa
  • Gaudensia Mutua, International AIDS Vaccine Initiative, Kenya
  • Alethea Cope, Wellcome Trust, UK

These discussions raised several key issues. In particular, it was noted that the clinical trial ecosystem trial was extremely complex, with multiple different stakeholders with differing interests. It was emphasised that no single organisation could solve every challenge, so stakeholders had to work together in equitable partnerships towards common goals.

Other issues raised included:

  • The need for funders to work together to avoid duplication of efforts and optimise the impact of investments.
  • The desirability of flexible and sustainable networks that could pivot to address multiple medical needs.
  • The importance of investing in infrastructure, including data systems, to facilitate clinical studies, and in long-term investment in networks.
  • The importance of building on what already exists rather than launching new initiatives from scratch.
  • The need to strengthen connections and coordination mechanisms between networks.
  • The desirability of national investment in clinical trial systems, for example through co-investment with partners, at the very least by providing support in kind.
  • The need to have greater transparency on domestic contributions, which could be used to demonstrate return on investment and support the development of investment cases.
  • The need to identify alternative sources of financing, such as from the private sector, through innovative financing mechanisms or cost-recovery initiatives (e.g. technical service provision).
  • The potential to engage patients and the general public to create public pressure for government investment in clinical research. 

Shingai concluded by highlighting the new global and regional context, including the WHO clinical trials guidance and global action plan, and the Africa CDC’s Ten-Year Clinical Trials Roadmap. These could guide efforts to develop a coordinated clinical trials ecosystem built on what already exists and with close alignment across funders. 

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