Submission ID 130680
| Issue/Objective | Global advances in genomic research and precision medicine risk exacerbating health inequities if low- and middle-income regions remain underrepresented. Africa, despite its high genetic diversity and disproportionate disease burden, contributes minimally to the global genomic evidence base, raising concerns about equity, relevance, and sovereignty in health research. This study examines structural gaps in Africa's genomic research landscape and assesses their implications for global health equity, aligning with the need to address upstream determinants that shape access to innovation. |
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| Methodology/Approach | Using data extracted from ClinicalTrials.gov as of March 2026, we identified and analyzed all interventional genomic and biomarker trials conducted in African countries. Trial density was contextualized against available research infrastructure, including biobank counts by region and projects supported through the Human Heredity and Health in Africa (H3Africa) Initiative. Inequality indices across five dimensions, volume, cancer research, genomic capacity, trial completion, and geographic distribution, were computed to quantify the research gap. |
| Results | A total of 189 genomic trials and 1,149 biomarker trials were identified, representing less than 1% of all globally registered trials and approximately 1.4% of genomic trial activity in the United States. Africa accounts for only 2.2% (2,182 of 99,319) of global cancer trials. In terms of infrastructure, the continent operates an estimated 23 biobanks, compared to 350 in the US, 300 in Europe, and 120 in Asia. Inequality indices exceeded 0.85 across most dimensions, with the trial completion index registering a near-absent value of 0.05, indicating a critical implementation gap. The H3Africa Initiative supports 51 projects and remains the principal scaffold for continental genomic collaboration. |
| Discussion/Conclusion | While genomic research in Africa is incrementally expanding, substantial structural deficits in infrastructure, technical expertise, and data governance persist. These constraints perpetuate dependence on external institutions for advanced genomic analyses and translational applications. Targeted investment and policy reform are required to support the development of sovereign and sustainable precision medicine systems across the continent. Advancing these priorities is essential to ensure that precision medicine innovations are inclusive, contextually relevant, and contribute meaningfully to global health equity, aligning with the need to address upstream determinants that shape access to innovation. |
| Presenters and Affiliations | Muruhukye Jacob Makerere Muruhukye Jacob Makerere |
