18/01/2019
It is a great joy for me to use the occasion of my birthday to kickstart the launching of my latest and biggest initiative yet. The Clinical Research Equity Agency Inc (https://clinirea.org/) is a non-profit corporation registered in the State of Massachusetts USA with the goal of advancing the inclusiveness of African populations and US minority groups in clinical research, as a means of promoting global health equity.
Here is a snapshot of the problem we are addressing:
Africa has a population of 1.2 billion people. With a population growth rate of 2.5% p.a., Africa’s population is expected to hit 2 billion people by 2038. Africa is therefore the second largest, second most populous continent on earth, but more importantly, the most important emerging market in the world.
As of January 2019, the Clinical Trial Database had 8003 trials registered in all of Africa as opposed to 117,756 clinical trials registered in the United States alone. What this means is that of all the hundreds of thousands of drugs, medical devices, clinical procedures, and public health interventions that are used to treat billions of Africans each year, less than 7% are actually tested in Africa.
Within the United States itself, it has been reported that White males constitute over 70% of the total population of volunteers who participate in clinical trials. Minority populations (Hispanics, Africans, Asians, and Native Americans) are underrepresented in clinical trials for drugs, devices, and interventions that are eventually approved for use on them.
These inequities in clinical research have devastating consequences in terms of human lives and scarce resources, with Africa and US minority communities bearing the brunt:
• On average, about 4,500 drugs and devices are recalled from the market each year in the US alone.
• Thousands of medical devices malfunctions and failures are reported to the FDA each year. In Africa, this is common knowledge among health workers, although these incidents often go unreported.
• The rate of resistance to antibiotic and antiviral drugs has recorded an alarming increase in recent years.
• Treatment failure is becoming the next big problem as an increasing number of patients are not responding to the drugs that are deemed the most effective drugs.
• Prescription drugs adverse effects and medical errors are now ranked as the 3rd cause of death in America. In many parts of Africa, death by medicine has become a norm, and no one reports it or keeps track of it.
• Each year, African governments and their foreign partners pump billions of dollars into public health initiatives whose outputs pale in comparison to the investments.
• Weak monitoring systems and almost non-existent ethics committees leave African populations at the mercy of practitioners, researchers, drugs, and devices, with no accurate statistics of how many of them get harmed or killed each year by these actors. For example, the North West Region of Cameroon has two medical schools and over twenty health professions institutions, none of which had an Institutional Review Board (IRB) as of December 2018, yet thousands of research projects are conducted by staff and students of these institutions each year, involving actual people in the hospitals and communities.
• The failure and recall of drugs and devices also means billions of dollars’ worth of loss to the pharmaceutical companies that developed these drugs and devices.
Mitigating this crisis requires an innovative approach that engages all the stakeholders on the continuum of the Research, Development, and Care (RDC). The Clinical Research Equity Agency was founded as a response to this global challenge.
If you are a health professional in any discipline (or student health professional) you are invited to partner with us in this initiative by filling our free online membership registration form at https://clinirea.org/institute/. We use the membership portal to create a pool of professionals and future professionals that we will train and mentor, and use as inroads into the communities we work in.
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Thank you.
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