Former colonial powers remain disproportionately represented as sponsors in thei...
Africa Trials
3,515
US Trials
159,433
Gap Ratio
45x
Nations
54
Key Finding
Africa hosts 23,873 trials across 54 nations with extreme geographic concentration.
Regional Comparison
Distribution Analysis
Inequality Profile
Temporal & Structural
Why It Matters
Former colonial powers remain disproportionately represented as sponsors in their former colonies — France in Francophone Africa, UK in Anglophone Africa — perpetuating dependency structures.
The Evidence 128 words · target 156
In the governance and sovereignty of African clinical trials, does the pattern of colonial legacy in sponsorship 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. Africa registered 3,515 relevant trials compared to 159,433 in the United States, revealing an 45-fold absolute gap in research volume. The Herfindahl-Hirschman index reached 3472.872, exceeding the threshold of 0.25 that indicates a highly concentrated distribution. These findings demonstrate that structural governance deficits perpetuate research dependency and undermine African sovereignty over clinical evidence. Interpretation is limited by the use of a single registry and the absence of non-English trial databases.
Sentence Structure
Question
In the governance and sovereignty of African clinical trials, does the pattern of colonial legacy in sponsorship 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
Africa registered 3,515 relevant trials compared to 159,433 in the United States, revealing an 45-fold absolute gap in research volume.
Interpretation
The Herfindahl-Hirschman index reached 3472.
Boundary
872, exceeding the threshold of 0.
Extra
25 that indicates a highly concentrated distribution.
Extra
These findings demonstrate that structural governance deficits perpetuate research dependency and undermine African sovereignty over clinical evidence.
Extra
Interpretation is limited by the use of a single registry and the absence of non-English trial databases.