E156 Micro-Paper · Africa Clinical Trials

Cancer Trial Landscape

Cancer is Africa's fastest-growing killer, but the trial landscape is dominated ...

Africa Trials
2,182
US Trials
49,054
Gap Ratio
22x
Nations
54
Africa hosted 2,182 cancer trials versus 49,054 in the United States, a 22-fold disparity in research investment.
Phase Distribution Africa US Europe Phase 1 7 37.6 63.5 Phase 2 21 289.9 177.3 Phase 3 72 927.2 464.4 Phase 4 2 22.7 16.4 927.2 2
Cancer Trial Landscape 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
Cancer Trial Landscape Lorenz Curve 0% 0% 25% 25% 50% 50% 75% 75% 100% 100% Gini = 0.711
Contribution Breakdown 11752 Egypt 3654 South Afri 809 Uganda 788 Kenya 540 Tunisia 2814 Others
No data
Research Profile Volume Growth Phase3 Complete Diversity
Enrollment Distribution Africa Reference 1000 2000 3000
Enrollment Density Africa Reference 500 1000 1500 2000
Why It Matters

Cancer is Africa's fastest-growing killer, but the trial landscape is dominated by HIV-related cancers (Kaposi, cervical) while the epidemiological transition brings rising breast, prostate, and colorectal cancers.

In the burden-versus-investment landscape of African health research, does the distribution of cancer 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 Herfindahl-Hirschman concentration index as the primary estimand using registry metadata for each nation. Africa hosted 2,182 cancer trials representing 9.1% of its total portfolio compared to 49,054 in the United States and 28,724 in Europe. The Herfindahl-Hirschman index reached 3472.872, exceeding the threshold of 0.25 that indicates a highly concentrated distribution. These results expose a fundamental mismatch between where disease burden falls and where research investment flows across Africa. Interpretation is limited by the use of a single registry and the absence of non-English trial databases.
Question

In the burden-versus-investment landscape of African health research, does the distribution of cancer 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 Herfindahl-Hirschman concentration index as the primary estimand using registry metadata for each nation.

Robustness

Africa hosted 2,182 cancer trials representing 9.

Interpretation

1% of its total portfolio compared to 49,054 in the United States and 28,724 in Europe.

Boundary

The Herfindahl-Hirschman index reached 3472.

Extra

872, exceeding the threshold of 0.

Extra

25 that indicates a highly concentrated distribution.

Extra

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

Extra

Interpretation is limited by the use of a single registry and the absence of non-English trial databases.