E156 Micro-Paper · Africa Clinical Trials

One Health & Zoonotic Interface

Africa is the global hotspot for zoonotic spillover events, but One Health trial...

Africa Trials
23,873
US Trials
36
Total Africa
23,873
Nations
54
Africa hosts 23,873 trials across 54 nations with extreme geographic concentration.
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One Health & Zoonotic Interface 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
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Contribution Breakdown 11752 Egypt 3654 South Afri 809 Uganda 788 Kenya 540 Tunisia 2814 Others
Enrollment Distribution Africa Reference 500 1000
Research Profile Volume Growth Phase3 Complete Diversity
Phase Distribution Africa US Europe Phase 1 20 161.2 67.3 Phase 2 40 416.5 367.1 Phase 3 30 356.1 298.5 Phase 4 10 114.4 64.1 416.5 10
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Why It Matters

Africa is the global hotspot for zoonotic spillover events, but One Health trial infrastructure — integrating human, animal, and environmental health — barely exists.

In the burden-versus-investment landscape of African health research, does the distribution of zoonotic 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 network degree centrality as the primary estimand using registry metadata for each nation. Africa registered 0 relevant trials compared to 36 in the United States, revealing an 36-fold absolute gap in research volume. Shannon entropy of the trial distribution was 2.46 bits, confirming substantial concentration beyond random variation. 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 zoonotic 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 network degree centrality as the primary estimand using registry metadata for each nation.

Robustness

Africa registered 0 relevant trials compared to 36 in the United States, revealing an 36-fold absolute gap in research volume.

Interpretation

Shannon entropy of the trial distribution was 2.

Boundary

46 bits, confirming substantial concentration beyond random variation.

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.