Nairobi, Kenya – Africa is trailing the rest of the world in  conducting clinical studies on COVID-19 vaccines and drugs. Less than 70 registered studies for drugs and vaccines are currently taking place in Africa, out of more than 1000 studies being conducted globally.

Only 8 of 102 clinical vaccine trials were being conducted in Africa. And out of 1098 clinical studies on potential drugs underway around the world, a mere 56 of them were being done on the continent, data presented to an African Science journalists forum in Nairobi last week showed.

According to Dr Borna Nyaoke, senior clinical project manager for the Drugs for Neglected Diseases Initiative (DNDi)-Africa, part of the reason for the low number of trials was due to lack of government funding for the studies.

Nyaoke noted that successful treatments or vaccines for COVID-19 largely relied on the breadth of trials conducted, with large experiments being more likely to succeed compared to ones enrolling fewer study participants. Yet enrolling, finding, and monitoring a large number of study volunteers is a costly and time-consuming endeavor.

“We need to see African governments committing additional funding for drugs and vaccine trials, finance more international collaborations and engage pharmas for more research to happen on our continent,” she told a virtual pre-conference event hosted by the Media for Science Health and Agriculture (MESHA).

Vaccine studies were only taking place in seven countries, five of them in South Africa. Trials for drugs were more widely distributed, happening in 13 different countries. Egypt has 36 trials for potential COVID-19 treatments underway, followed by South Africa with eight.

More Research Into Mild & Moderate COVID-19 Treatments Required

And most of the drug and vaccine experiments currently taking place in developed countries of the global north and parts of Asia are concentrated on severe and advanced cases of the disease, Dr Nyaoke observed. But more research was required to understand how to treat mild and moderate cases to help benefit places like Africa, which has a comparatively higher rate of mild and moderate disease.

“Right now only a few studies are happening in the Global South, and as such, trials may not be as conclusive. We have large populations in these regions of the world with over 1 billion people in Africa for example that can provide an adequate sample size for a trial,” she said.

There was therefore a great need for COVID-19 clinical trials in “Africa led by Africans” given the continent’s unique genetic diversity, and existing capacity for conducting such trials. Many efforts by organisations such as DNDi have helped set up a rich research ecosystem across the continent.

“Africa displays genetic diversity which if not represented, trial findings cannot be generalised to our large populations. Responses to drugs or vaccines can be influenced by, among other things, human genetics,” she said.

Conducting clinical studies in Africa would have many advantages besides benefiting from the most genetically diverse population in the world, as such trials also need to be well designed and “adequately powered to generate evidence” – meaning they must enroll massive numbers of people.

In addition, Dr Nyaoke said large, well-conducted clinical trials are urgently needed to support guidelines on prevention and clinical management of COVID-19 in “resource-constrained settings” such as Africa.

Local Trials Will Help Build Local Trust

Local trials would also help influence policy change since policymakers are more apt to trust local evidence. Trials can help support faster adoption of new tools into policy, access to new tools, and development of potential life-saving innovations.

Besides, Nyaoke opined, locally developed disease remedies easily gained trust of communities as local researchers were more likely to win and maintain trust of their communities.

To increase the number of clinical trials in the poor regions of the world, the DNDi and its partners have formed the COVID-19 Clinical Research Coalition, a global partnership aimed at accelerating clinical research in resource-limited settings.

Founded by a coalition of organizations, which include the DNDi and Infectious Diseases Data Observatory (IDDO) among others, the group aimed to advance research in therapeutics, preventive medicines, vaccines, diagnostics, social science, epidemiology and modeling.

Some 22 African countries have so far joined the group.

The partnership formed in March also hoped to establish a vibrant dialogue within a network of research and allied institutions around the world, to facilitate and accelerate research adapted for resource-limited settings, and facilitate prompt sharing of findings to ensure accelerated learning for speedy review of evidence and its adoption into guidelines.

Members of the partnership include research institutions, universities, Non-Governmental Organisations (NGOs) and governments from all regions of the world.

Image Credits: DNDi.