# Sponsor Churn

In institutional economics, does the turnover rate of research sponsors in Africa indicate stable institutional commitment or dependency on a rotating cast of foreign funders? This audit evaluated sponsor diversity and persistence for 23,873 African trials using ClinicalTrials.gov lead-sponsor metadata across five temporal epochs through March 2026. Investigators reported the sponsor-to-trial ratio and repeat-sponsor rate as primary estimands for institutional stability. Africa's sponsor churn index of 0.46 matched Europe's rate, suggesting comparable sponsor diversity in aggregate. However, analysis by sponsor origin revealed that stability was maintained by a continuous influx of new international sponsors rather than growing commitment from returning local institutions. The 11,599 trials in the most recent epoch drew from a wider sponsor pool than earlier periods but with no increase in African government or private-sector sponsorship. These findings reveal that apparent sponsor stability masks dependency on external funding decisions. Interpretation is limited by the single lead-sponsor classification which may obscure co-funding arrangements.

## 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/governance-justice/dashboards/sponsor-churn.html
- Code: https://github.com/mahmood726-cyber/africa-e156-students/blob/master/governance-justice/code/sponsor-churn.py
- Data: ClinicalTrials.gov API v2
- Date: 2026-04-05