Community advisory structure in African clinical trials: A registry-based analysis

Abstract

Clinical trials in Africa rarely report formal community-engagement structures, raising questions about the extent to which research is locally driven. This analysis reviewed 23,873 African interventional trial using ClinicalTrial.gov text field to identify explicit participatory approaches throughout March 2026. Only 203 African trials (0.9%) reported formal community advisory structures, compared to 1,960 (1.0%) in the United States ¹. Despite this low proportion, engagement trials demonstrated better completion and longer follow-up than non-engagement trials, suggesting community engagement methods improve research sustainability. Community advisory boards were most common in HIV research programs, with 1,793 out of 8,496 global HIV trials (21.1%) conducted in Africa, reflecting PEPFAR-supported engagement requirements ². These findings suggest promising approaches to ethical clinical research emerging and focus on the actual health needs of the community ³. Although the findings may not capture the full picture as the keyword method may underestimate informal community engagement, the findings support a shift toward collaborative, community-driven research.