E156 Micro-Paper · Africa Clinical Trials

Epilepsy Treatment Gap

The epilepsy treatment gap in Africa exceeds 80% — four out of five people with ...

Africa Trials
73
US Trials
1,017
Gap Ratio
14x
Nations
54
Africa hosted 73 epilepsy trials versus 1,017 in the United States, a 14-fold disparity in research investment.
Epilepsy Treatment Gap 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
Epilepsy Treatment Gap Lorenz Curve 0% 0% 25% 25% 50% 50% 75% 75% 100% 100% Gini = 0.711
Regional Comparison Africa US Europe 0 500 1000
No data
Contribution Breakdown 11752 Egypt 3654 South Afri 809 Uganda 788 Kenya 540 Tunisia 2814 Others
Research Profile Volume Growth Phase3 Complete Diversity
Enrollment Distribution Africa Reference 500 1000 1500 2000 2500
No data
Why It Matters

The epilepsy treatment gap in Africa exceeds 80% — four out of five people with epilepsy receive no treatment — yet the trial pipeline for affordable antiepileptic regimens is nearly empty.

In the burden-versus-investment landscape of African health research, does the distribution of epilepsy 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 rate ratio comparing Africa to other regions as the primary estimand using registry metadata for each nation. Africa hosted 73 epilepsy trials (0.3% of its portfolio) compared to 1,017 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 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 epilepsy 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 rate ratio comparing Africa to other regions as the primary estimand using registry metadata for each nation.

Robustness

Africa hosted 73 epilepsy trials (0.

Interpretation

3% of its portfolio) compared to 1,017 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 limited by the use of a single registry and the absence of non-English trial databases.