# Global Diseasome Mismatch

In global health systems, does the alignment between disease burden and clinical trial investment reveal a systematic mismatch in Africa? This cross-sectional analysis compared condition-specific trial volumes to WHO disability-adjusted life year estimates across Africa (23,873 trials) and the United States (190,644) using ClinicalTrials.gov API v2. Investigators reported the burden-to-trial ratio per condition as the primary estimand. Cancer trials numbered 2,182 in Africa versus 49,054 in the United States, a 22x gap, while cardiovascular research showed 1,426 versus 19,566 (14x). Mental health had only 174 African trials against 2,996 American trials, a 17x disparity. Only malaria (531 African versus 125 American trials) showed Africa leading the global research effort. These findings reveal that Africa's trial portfolio is misaligned with its epidemiological transition toward non-communicable diseases. Interpretation is limited by the indirect mapping between trial conditions and DALY categories.

## References

1. Isaakidis P, et al. "Relation between burden of disease and randomised evidence in sub-Saharan Africa." BMJ. 2002;324:702.
2. GBD 2019 Diseases and Injuries Collaborators. "Global burden of 369 diseases." Lancet. 2020;396:1204-1222.
3. ClinicalTrials.gov API v2 Documentation. U.S. National Library of Medicine.

## Note Block

- Type: research
- App: https://mahmood726-cyber.github.io/africa-e156-students/health-disease/dashboards/global-diseasome-mismatch.html
- Code: https://github.com/mahmood726-cyber/africa-e156-students/blob/master/health-disease/code/global-diseasome-mismatch.py
- Data: ClinicalTrials.gov API v2
- Date: 2026-04-05