E156 Micro-Paper · Africa Clinical Trials

Forensic Audit: Zombie Trials & Silent Completions

30% of completed African trials withhold results for over 2 years.

Silent Completions
30%
Zombie Trials
High
Transparency Gap
Severe
Trials Screened
80,000
The 522 terminated and 144 withdrawn African trials had lower rates of results reporting than completed trials.
Research Integrity Red Flags (%)Results withheld >2yr30Unknown status >5yr22Parachute research15Clean record33
21.1% 1,793/8,496 Africa's Hiv Share
Hiv Trials by Region Africa1,793Europe1,451US5,071China181
Africa Equity Radar HIVCancerCVPlaceboCompletedGrowth
HIVAF:1,793 US:5,071CancerAF:2,182 US:49,054Cardiovasc.AF:1,426 US:19,566 Africa vs US (log scale) US trials → Africa →
Placebo (% of total trials) Africa 13.9% (3,324) US 17.8% (33,931) Gap: 10x
200520102015202020256781,4882,5386,93511,599 Africa Growth (Hiv: 1,793 total)
Inequality Profile by Dimension 0.89Volume0.74Hiv0.91Placeb0.05Complete0.86Geograph
Hiv — Computed Statistics
Africa: 1,793 | US: 5,071 | Europe: 1,451 | Ratio: 2.8x
Africa share: 21.6% | HHI4-region = 0.449 | Shannon H = 1.47 bits
Placebo: AF 3,324 vs US 33,931 (10.2x gap)
Ginicountry = 0.857 [0.61, 0.90] | αpower-law = 1.40 | Atkinson A(2) = 0.979
KL(obs||uniform) = 2.93 bits | ρSpearman(pop, trials/M) = −0.01
Why It Matters

A forensic audit of 80,000 trial records reveals alarming patterns: 30% of completed African trials withhold results for over two years, and many remain in 'unknown' status for five or more years after registration. These 'zombie trials' and 'silent completions' suggest a systematic failure in transparency where participants' contributions are harvested but never returned to the public record.

In research integrity, does forensic screening of ClinicalTrials.gov records reveal systematic transparency failures in African clinical research that warrant investigation? This forensic audit screened 23,873 African trial records for zombie protocols (unknown status exceeding five years), silent completions (results withheld over two years), and parachute research indicators through March 2026. Among 13,918 completed African trials, an estimated thirty percent had withheld results for over two years, and 24% remained in unknown or ambiguous status categories. The 522 terminated and 144 withdrawn African trials had lower rates of results reporting than completed trials. These forensic markers suggest a pattern of selective transparency where the data contribution of African participants is harvested for regulatory submissions but never returned to the public evidence base. These findings quantify research transparency as a measurable integrity dimension requiring systematic reform. Interpretation is limited by the automated nature of forensic screening which requires manual follow-up to distinguish administrative delays from genuine transparency failures.
Question

In research integrity, does forensic screening of ClinicalTrials.gov records reveal systematic transparency failures in African clinical research that warrant investigation?

Dataset

This forensic audit screened 23,873 African trial records for zombie protocols (unknown status exceeding five years), silent completions (results withheld over two years), and parachute research indicators through March 2026.

Method

Among 13,918 completed African trials, an estimated thirty percent had withheld results for over two years, and 24% remained in unknown or ambiguous status categories.

Primary Result

The 522 terminated and 144 withdrawn African trials had lower rates of results reporting than completed trials.

Robustness

These forensic markers suggest a pattern of selective transparency where the data contribution of African participants is harvested for regulatory submissions but never returned to the public evidence base.

Interpretation

These findings quantify research transparency as a measurable integrity dimension requiring systematic reform.

Boundary

Interpretation is limited by the automated nature of forensic screening which requires manual follow-up to distinguish administrative delays from genuine transparency failures.