Study reveals urgent need to boost cardiovascular clinical trials in Africa

A recent study, recently published in the journal Circulation: Cardiovascular Quality and Outcomes, has cast a spotlight on the concerning dearth of clinical trials in cardiovascular medicine across Africa. While there has been a noticeable uptick in trials conducted within African centres, experts are sounding the alarm about the critical necessity to strengthen the continent’s research infrastructure.

Authored by Abdelrahman Abushouk from the Cleveland Clinic, USA, and a team of colleagues, the study brings into sharp focus the glaring discrepancy between Africa’s substantial population of 1.4 billion and its meagre 2% contribution to published or registered clinical trials.

Despite a positive trajectory marked by an increasing number of trials conducted in African centres—41 between 1990–1999, 30 between 2000–2009, and 108 between 2010–2019—the research underscores that 37 out of Africa’s 54 countries have not contributed to any cardiovascular research during this period. The study emphasizes that this underrepresentation is particularly disconcerting, given the immense potential for scientific advancement through research involving the continent’s vast, diverse, and largely treatment-naive population.

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One plausible factor contributing to the limited output of African-led clinical trials is the scarcity of cardiologists. Africa is estimated to have only around 2,000 cardiologists, in stark contrast to the 25,000 cardiologists in the USA. Experts advocate for broadening the scope of cardiovascular researchers beyond traditional cardiologists to include research methodologists.

Funding emerges as another pivotal concern, with 91 trials failing to disclose their funding sources, and 20 acknowledging no external funding. Among the remaining 68 trials, funding was derived from private sources (35.7%), academic institutions (28.6%), governmental bodies (28.6%), and non-governmental entities (7.1%).

To address these pressing challenges, the study’s authors champion multifaceted interventions. While initiatives like the Clinical Trials Community online platform and the Pan-African Clinical Trials Registry are steps in the right direction, more robust actions are imperative. This includes establishing additional clinical research sites, implementing standardized regulatory frameworks, widespread adoption of electronic medical records, and bolstering open-access publishing and institutional partnerships.

Efforts to fortify research infrastructure and foster international collaboration stand as critical components to ensure that Africa’s diverse and treatment-naive population can significantly contribute to advancing scientific comprehension in cardiovascular medicine. This study serves as a clarion call, urging the global heart health community to rally together, bridge the existing gap, and collectively make an enduring impact on heart health for all.

Article by Nyokabi Wanjiku

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https://www.ahajournals.org/doi/abs/10.1161/CIRCOUTCOMES.122.009895