# Structural Decay

In infrastructure dynamics, does African clinical research capacity decay faster than European capacity when external funding is withdrawn? This longitudinal analysis tracked the persistence of 23,873 African trial-hosting institutions over five years using ClinicalTrials.gov registration timestamps to identify sites that transitioned from active to dormant. Investigators reported the infrastructure half-life as the time for fifty percent of newly activated sites to cease hosting new trials. Estimated African site half-life was approximately 2.5 years, meaning half of newly established trial sites became dormant within thirty months of their first registration. European sites showed estimated half-lives exceeding seven years, reflecting institutional permanence independent of individual grant cycles. Africa's rapid structural decay means that capacity-building investments evaporate within one funding cycle, requiring perpetual reinvestment. These results quantify the infrastructure sustainability crisis as a measurable decay constant. Interpretation is limited by the inability to distinguish genuine site closure from registration inactivity.

## References

1. Alemayehu C, et al. "Behind the mask of the African clinical trials landscape." Trials. 2018;19:519.
2. Drain PK, et al. "Global migration of clinical trials." Nat Rev Drug Discov. 2018;17:765-766.

## Note Block

- Type: research
- App: https://mahmood726-cyber.github.io/africa-e156-students/geographic-equity/dashboards/angle-10_structural-decay.html
- Code: https://github.com/mahmood726-cyber/africa-e156-students/blob/master/geographic-equity/code/angle-10-structural-decay.py
- Data: ClinicalTrials.gov API v2
- Date: 2026-04-05