# The South-South Axis of Discovery

In the geopolitics of clinical research, does the emergence of South-South collaboration networks signal a shift toward research sovereignty for African institutions? This network analysis evaluated collaborator relationships for 23,873 African trials on ClinicalTrials.gov, classifying partnerships as South-North, South-South, or domestic. Investigators reported the South-South collaboration ratio as the primary estimand for research independence. Approximately twelve percent of African multi-partner trials involved exclusively Southern collaborators from India, China, or Brazil, exceeding the eight percent pan-African collaboration rate. Africa-India research links were strongest in infectious disease where 1,793 African HIV trials and 531 malaria trials overlapped with Indian generic drug development networks. Pure domestic trials accounted for an estimated twenty-five percent of the total, with Egypt and South Africa showing the highest sovereign research rates. These findings suggest a nascent alternative axis of discovery outside traditional Northern funding structures. Interpretation is limited by heuristic identification of collaborator locations.

## References

1. Alemayehu C, et al. "Behind the mask of the African clinical trials landscape." Trials. 2018;19:519.
2. Drain PK, et al. "Global migration of clinical trials." Nat Rev Drug Discov. 2018;17:765-766.

## Note Block

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