E156 Micro-Paper · Africa Clinical Trials

Local Manufacturing Capacity

Africa manufactures less than 2% of the medicines it consumes. Trials using loca...

Africa Trials
11
US Trials
214
Gap Ratio
19x
Nations
54
Africa hosts 23,873 trials across 54 nations with extreme geographic concentration.
Burden vs Investment 50 100 150 200 50000 100000 150000 Africa US Europe
Local Manufacturing Capacity by Country Egypt: 11752 Algeria: N/A Morocco: 162 Tunisia: 540 Senegal: N/A Ghana: 261 Nigeria: 379 Cameroon: N/A DRC: N/A Ethiopia: 302 Kenya: 788 Uganda: 809 Tanzania: 460 Rwanda: N/A South Africa: 3654 Egy 11752 Sou 3654 Uga 809 Ken 788 Tun 540 162 11752
No data
Contribution Breakdown 11752 Egypt 3654 South Afri 809 Uganda 788 Kenya 540 Tunisia 2814 Others
Enrollment Distribution Africa Reference 10000 20000
Research Profile Volume Growth Phase3 Complete Diversity
Growth 2010-2026 Before After Africa 0 0 US 0 0 Europe 0 0
Regional Comparison Africa US Europe 0 100 200
Why It Matters

Africa manufactures less than 2% of the medicines it consumes. Trials using locally manufactured products could build pharmaceutical sovereignty, but they remain extremely rare.

In the governance and sovereignty of African clinical trials, does the pattern of local manufacturing capacity 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 Spearman rank correlation as the primary estimand using registry metadata for each nation. Africa registered 11 relevant trials compared to 214 in the United States, revealing an 19-fold absolute gap in research volume. Temporal analysis showed 17.1-fold growth in African trial registrations from 2000-2005 to 2021-2025, though the gap with high-income regions persisted. 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.
Question

In the governance and sovereignty of African clinical trials, does the pattern of local manufacturing capacity 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 Spearman rank correlation as the primary estimand using registry metadata for each nation.

Robustness

Africa registered 11 relevant trials compared to 214 in the United States, revealing an 19-fold absolute gap in research volume.

Interpretation

Temporal analysis showed 17.

Boundary

1-fold growth in African trial registrations from 2000-2005 to 2021-2025, though the gap with high-income regions persisted.

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.