Ready to Fly: Building Clinical Trial Capacity in Africa

Last week, I narrowly avoided running over a chick of an Abyssinian Thrush in my driveway. My son saw it. With great relief, I retrieved the chick, brought it indoors, sheltered it, fed it, fussed over it – the whole family was delighted to be part of the ‘care system’. What food should we give it? How should we protect it from a stray cat? Is it healthy? How can we reunite it with the parents? How should we make sure it doesn’t become too dependent on us? How can we help it start to fly? We were full of questions. The answers came through trial and error, with a good dose of common sense. And Google.

We had to be innovative – with the food, the feeding technique, the shelter, finding the mother, etc. Fortunately, the chick did not have difficulty feeding and it did not seem injured or in distress.  

We tried to simulate its natural environment in the house. It was always under the watchful eyes of an adult. Thankfully, the mother came the next day and began feeding it. Within two days, the little bird was hopping around and thriving. Its eagerness to fly was clear to see. We were all keen for it to fly off with its mother so that it could experience a full, happy life. But it was clear the little bird wasn’t able to set off just yet – a clear tension remained between its innate desires and its developing abilities. 

This intense, albeit brief, encounter, has made me think about the fledgling clinical trials landscape and practice in Africa. Africa presents considerable potential for clinical research due to its large population, significant healthcare needs, and select high-quality trial sites – but the continent has needed some help to bridge important gaps in skills and expertise. The ClinOps capacity building programme is working to change that. As a comprehensive virtual training platform, it addresses all critical aspects of clinical trials—from foundational principles to ethics and performance metrics. The ClinOps programme also offers great opportunities for clinical trialists, academic institutions, product development partners and industry stakeholders to engage in meaningful partnership.

There have been other promising developments. Looking at the bigger picture, there has been an increased focus on expanding access to essential medicines in Africa through local manufacturing. The African Union’s Agenda 2063 and the Pharmaceutical Manufacturing Plan for Africa are notable policy developments. The United Nations General Assembly declared 2016-2025 the Third Industrial Development Decade for Africa. The 2021 UNIDO summit, themed “Strengthening Africa’s Pharmaceutical Industry – learning the lessons from COVID19,” recognised both the vulnerability of Africa resulting from its reliance on imports of vaccines and essential medicines, as well as the missed opportunity of boosting public health and economic development across Africa and beyond. 

Recently, the continent has taken steps to produce vaccines and healthcare products by creating the Regional Capability and Capacity Networks (RCCNs), coordinated by Africa CDC. This initiative, which includes CDT-Africa as a participant, focuses on workforce development and research and development.

Given all of these developments, Africa’s clinical trial capacity is showing important signs of progress – just as our little bird built his strength. However, I see the tension here, too. While there is genuine enthusiasm and some significant early advances, the continent has a long way to go to achieve full operational independence in clinical trials and biomanufacturing. Stakeholders—including governments, intergovernmental bodies, industry, and funders—are invested in seeing Africa achieve self-sufficiency in the pharmaceutical domain. Yet, the slow pace of advancement can cause legitimate frustration. 

As a leader of an African centre dedicated to strengthening regional capabilities and partnerships—through initiatives such as the ClinOps programme, advanced skills development, and biopharmaceutical research and development—I am deeply committed to building robust infrastructure for world-class clinical trials and local biomanufacturing. We’re working to extend this clinical trial excellence throughout Africa—for the benefit of the continent and the global community. 

I extend my sincere appreciation to all partners for recognizing the importance of capacity building in clinical trials and product development across Africa. Your sustained and active support are vital to this mission. 

Our passion is high, and we’ve done the hard work to build the skills that Africa needs. If we keep up the engagement and energy for just another few years, I know we’ll be ready to fly. 

Professor Abebaw Fekadu (MD, MSc, PhD, MRCPsych)

Centre Leader, CDT-Africa, Addis Ababa University

www.cdt-africa.org