E156 Micro-Paper · Africa Clinical Trials

Sickle Cell Disease Neglect

Sickle cell disease affects more Africans than any other genetic condition, yet ...

Africa Trials
9
US Trials
574
Gap Ratio
64x
Nations
54
Africa hosted 9 sickle cell disease trials versus 574 in the United States, a 64-fold disparity in research investment.
Sickle Cell Disease Neglect Lorenz Curve 0% 0% 25% 25% 50% 50% 75% 75% 100% 100% Gini = 0.711
Sickle Cell Disease Neglect 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 0 200 400 600
Contribution Breakdown 11752 Egypt 3654 South Afri 809 Uganda 788 Kenya 540 Tunisia 2814 Others
Enrollment Distribution Africa Reference 1000 2000
No data
Research Profile Volume Growth Phase3 Complete Diversity
Growth 2010-2026 Before After Africa 0 0 US 0 0 Europe 0 0
Why It Matters

Sickle cell disease affects more Africans than any other genetic condition, yet trial investment is a fraction of what cystic fibrosis receives in the US, reflecting whose diseases get funded.

In the burden-versus-investment landscape of African health research, does the distribution of sickle cell disease 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 9 sickle cell disease trials (0.0% of its portfolio) compared to 574 in the United States, yielding a 0.0-fold disparity in per-population investment. The Theil index of 1.288 confirmed between-country inequality, with decomposition showing most disparity arising from inter-regional gaps. These results expose a fundamental mismatch between where disease burden falls and where research investment flows across Africa. Interpretation is limited by reliance on ClinicalTrials.gov alone, which may undercount locally registered African studies.
Question

In the burden-versus-investment landscape of African health research, does the distribution of sickle cell disease 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 9 sickle cell disease trials (0.

Interpretation

0% of its portfolio) compared to 574 in the United States, yielding a 0.

Boundary

0-fold disparity in per-population investment.

Extra

The Theil index of 1.

Extra

288 confirmed between-country inequality, with decomposition showing most disparity arising from inter-regional gaps.

Extra

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

Extra

Interpretation is limited by reliance on ClinicalTrials.

Extra

gov alone, which may undercount locally registered African studies.