E156 Micro-Paper · Africa Clinical Trials

Antimicrobial Resistance Crisis

AMR kills more people in Sub-Saharan Africa than anywhere else, yet the continen...

Africa Trials
2
US Trials
123
Gap Ratio
62x
Nations
54
Africa hosted 2 antimicrobial resistance trials versus 123 in the United States, a 62-fold disparity in research investment.
No data
Antimicrobial Resistance Crisis 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
Regional Comparison Africa US Europe 0 50 100 150
Contribution Breakdown 11752 Egypt 3654 South Afri 809 Uganda 788 Kenya 540 Tunisia 2814 Others
Burden vs Investment 0 50 100 50000 100000 150000 Africa US Europe
Research Profile Volume Growth Phase3 Complete Diversity
Enrollment Distribution Africa Reference 400 600 800 1000
No data
Why It Matters

AMR kills more people in Sub-Saharan Africa than anywhere else, yet the continent has the fewest AMR-specific trials, least surveillance data, and weakest antibiotic stewardship infrastructure.

In the burden-versus-investment landscape of African health research, does the distribution of antimicrobial resistance trials across African nations reveal a systematic research gap? 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 ARIMA-forecast trend as the primary estimand using registry metadata for each nation. Africa hosted 2 antimicrobial resistance trials (0.0% of its portfolio) compared to 123 in the United States, yielding a 0.0-fold disparity in per-population investment. 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 results expose a fundamental mismatch between where disease burden falls and where research investment flows across Africa. Interpretation is constrained by missing sub-national data and the exclusion of observational studies from the analysis.
Question

In the burden-versus-investment landscape of African health research, does the distribution of antimicrobial resistance trials across African nations reveal a systematic research gap?

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 ARIMA-forecast trend as the primary estimand using registry metadata for each nation.

Robustness

Africa hosted 2 antimicrobial resistance trials (0.

Interpretation

0% of its portfolio) compared to 123 in the United States, yielding a 0.

Boundary

0-fold disparity in per-population investment.

Extra

Temporal analysis showed 17.

Extra

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

Extra

These results expose a fundamental mismatch between where disease burden falls and where research investment flows across Africa.

Extra

Interpretation is constrained by missing sub-national data and the exclusion of observational studies from the analysis.