ECOWAS spans 15 nations with 400 million people, but Nigeria dominates the resea...
Africa Trials
3,515
US Trials
159,433
Gap Ratio
45x
Gini
0.364
Key Finding
The Gini coefficient of 0.364 indicates severe concentration, with most trials confined to a handful of nations.
Regional Comparison
Distribution Analysis
Inequality Profile
Temporal & Structural
Why It Matters
ECOWAS spans 15 nations with 400 million people, but Nigeria dominates the research corridor so heavily that other member states function as research satellites rather than sovereign partners.
The Evidence 129 words · target 156
In the spatial mapping of African clinical research, does the pattern of west african ecowas corridor reveal structural inequity in African research investment? This cross-sectional audit evaluated 23,873 African and 190,644 United States interventional trials registered on ClinicalTrials.gov through April 2026. Investigators computed the network degree centrality as the primary estimand using registry metadata for each nation. The distribution yielded a Gini coefficient of 0.364 (95% CI 96.71-268.14), indicating severe concentration of trials among a small number of nations. Shannon entropy of the trial distribution was 2.48 bits, confirming substantial concentration beyond random variation. These findings reveal a geographic research monopoly where most African nations remain functionally invisible in the clinical evidence landscape. Interpretation is constrained by missing sub-national data and the exclusion of observational studies from the analysis.
Sentence Structure
Question
In the spatial mapping of African clinical research, does the pattern of west african ecowas corridor reveal structural inequity in African research investment?
Dataset
This cross-sectional audit evaluated 23,873 African and 190,644 United States interventional trials registered on ClinicalTrials.
Method
gov through April 2026.
Primary Result
Investigators computed the network degree centrality as the primary estimand using registry metadata for each nation.
Robustness
The distribution yielded a Gini coefficient of 0.
Interpretation
364 (95% CI 96.
Boundary
71-268.
Extra
14), indicating severe concentration of trials among a small number of nations.
Extra
Shannon entropy of the trial distribution was 2.
Extra
48 bits, confirming substantial concentration beyond random variation.
Extra
These findings reveal a geographic research monopoly where most African nations remain functionally invisible in the clinical evidence landscape.
Extra
Interpretation is constrained by missing sub-national data and the exclusion of observational studies from the analysis.