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How Africa Can Save Medicine – Harnessing Genetic Diversity for Clinical Trials
It is time for scientists and researchers to hold more clinical trials in Africa to advance global healthcare and foster equitable medical innovation.
31 January, 2025

A shocking 23% of clinical trials for drugs and medical procedures took place in the United States in the year 2023. This was mainly due to easy access to equipment and investments in their medical sector. However, the results of these clinical trials are often constricted to the Caucasian population and rarely consider different genetic types and races. It was as Professor Kelly Chibale, the 2023 recipient of the royal Society’s Africa Prize, said “The status quo is that innovative medicines are discovered and developed largely in the global north. Then, five to ten years later, those innovative medicines are brought to Africa.” It is time for scientists and researchers to realise investing in clinical trials in Africa would help them combat global health challenges and improve access to lifesaving medicines and vaccine to help them better prepare for any future pandemic responses or even daily, basic routine.

One of the main arguments made in favour of hosting clinical trials in Africa is the large population and the genetic diversity present between the people. Africa currently holds about 18% of the global population but only an astounding 3% of clinical trials were conducted there last year. When large and diverse groups of people are integrated into these trials, scientists are able to understand and research the disease in a more systematic and inclusive way. An approach that ensures the results are widely applicable. One report from the U.S. National Institute of Mental health showed that out of the 379 clinical trials that took place in the United States, nearly half of the studies didn’t include complete demographic information about the participants, making the trials exclusive of people in practical applications.

Alternatively, a recent report of the clinical studies held in Rwanda to evaluate the treatment of schizophrenia with paliperidone palmitate were essential in catalysing the research and development of various mental health areas. Every dollar invested in this scheme resulted in a return of $405 and averted nearly 600 million disability-adjusted life years (DALY) between 2000 and 2022. This suggests that investing and empowering local researchers in Africa would not only administrate diverse results but also help empower and bolster the economy and health outcomes on a global scale.

Using the genetic diversity in Africa would help researchers better determine how the disease mutates and imbeds itself in people with different backgrounds. They would be able to analyse and achieve better results through a larger pool of data, resulting in an overall increase in the body of knowledge. For example, in the case of a chemotherapeutic drug called 5-fluorouracil, research noted the risk of adverse effects such as haematological toxicities tended to be higher in African-Americans. This information and knowledge would not have been possible, to determine and help save the lives of many, if sufficient data and research were not done.

Furthermore,  A report from 2022 by the National Bureau of Economic Research noted that conducting drug trials with a wide range of African Americans would help patients feel greater trust in the efficacy and outcome of the drug. This, alongside equal access, is essential to build a community where everybody feels positive and faithful in the medicine they are being given. Especially in a continent like Africa where CVD is one of the leading causes of morbidity and mortality, medicine taken to treat this is extremely important as it impacts the public severely. Africa reported an almost 50% increase in CVDs in the last three decades, a juxtaposition to the high-income countries that reported a decrease in such.  It is common knowledge amongst medical researchers that certain cardiovascular medications have differing effects between white people of European ancestry and African Americans. Hence, it is essential to formulate a medicine that accommodates both. By doing so, the many people affected by CVDs in Africa would have a higher chance of surviving and would be more likely to believe and trust the medicine they are being given.

Africa CDC Director Dr. John Nkengasong in a panel discussion at the Global Health Security Agenda Ministerial Meeting in Kampala, Uganda on 26 October 2017. Credits- CDC Global from Wikimedia Commons 

Lastly, to implement and perform these clinical trials in Africa, we must take into consideration the investment and time that must be dedicated to achieving this. It can be done right but there will be a lot of challenges to face as there is an urgent need for African governments to empower their public health infrastructures. It would be unethical and unjust to hold these trials in Africa without ensuring a fair allocation of resources that would enable Africans to reap the benefits of said trials. Corporations like Africa CDC (Centres for Disease Control and Prevention) and the African Medicines Agency are paramount in ensuring this success. It could therefore be argued, with a correct plan of action, Africa has the potential to transform and revitalise the field of medicine.

Manya Yadav
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