The absolute gap widened from 15,731 trials in 2000-2005 to 36,635 in 2021-2025 despite Africa's faster percentage growth rate.
Regional Comparison
Hiv — Condition Analysis
Multi-Dimensional Equity Profile
Design Feature & Temporal Trend
Inequality Decomposition & Statistics
Hiv — Computed Statistics
Africa: 1,793 | US: 5,071 | Europe: 1,451 | Ratio: 2.8x
Africa share: 21.6% | HHI4-region = 0.449 | Shannon H = 1.47 bits
Adaptive: AF 140 vs US 2,986 (21.3x gap)
Ginicountry = 0.857 [0.61, 0.90] | αpower-law = 1.40 | Atkinson A(2) = 0.979
KL(obs||uniform) = 2.93 bits | ρSpearman(pop, trials/M) = −0.01
Why It Matters
Tracking 150,000 registrations over 15 years, the 8-fold Europe-Africa trial gap has shown no significant narrowing. Hub concentration in Africa remained static — the same three cities dominate — while European research became increasingly decentralised. This structural equilibrium requires intentional policy intervention; gradual market-led improvement has demonstrably failed.
The Evidence 124 words · target 156
In time-series analysis, has the absolute and proportional gap between African and high-income research volumes narrowed over fifteen years of clinical trial registration? This longitudinal audit tracked registration volumes across five epochs from 2000 to 2025 using ClinicalTrials.gov metadata for 23,873 African and 190,644 United States trials. Africa grew from 678 trials in 2000-2005 to 11,599 in 2021-2025, while the United States grew from 16,409 to 48,234. The absolute gap widened from 15,731 trials in 2000-2005 to 36,635 in 2021-2025 despite Africa's faster percentage growth rate. Hub concentration remained static with Egypt, South Africa, and Kenya dominating throughout all epochs. These findings demonstrate that the research divide is a structural equilibrium resistant to organic growth. Interpretation is limited by retrospective registration of older trials.
Sentence Structure
Question
In time-series analysis, has the absolute and proportional gap between African and high-income research volumes narrowed over fifteen years of clinical trial registration?
Dataset
This longitudinal audit tracked registration volumes across five epochs from 2000 to 2025 using ClinicalTrials.gov metadata for 23,873 African and 190,644 United States trials.
Method
Africa grew from 678 trials in 2000-2005 to 11,599 in 2021-2025, while the United States grew from 16,409 to 48,234.
Primary Result
The absolute gap widened from 15,731 trials in 2000-2005 to 36,635 in 2021-2025 despite Africa's faster percentage growth rate.
Robustness
Hub concentration remained static with Egypt, South Africa, and Kenya dominating throughout all epochs.
Interpretation
These findings demonstrate that the research divide is a structural equilibrium resistant to organic growth.
Boundary
Interpretation is limited by retrospective registration of older trials.