The Bio-Digital Divide: Digital trial adoption and the Bio-digital gap in Africa
- PETER EBOT EYONG+−
- Jacob Muruhukye+−
- Rita Ewah Mbah+−
- Endurance Lum Ambe+−
- Vahid Esangaya Ntoung-Mbi +−
- Spritney Nashua Ninpa +−
- Tata Liza Ting+−
- Rhoda Chikula+−
- Grace Kemigisha +−
- Geofrey Emesu +−
- Ronald Bwambale +−
- Janepher Nabaasa +−
- Ebere Olive Nwanja+−
- Prossy Nabateregga +−
- Gloria Margaret Nanono+−
How to Cite
Abstract
Research question
In health technology innovation, does the adoption of decentralized and digital trial method indicate a growing bio-digital gap between African and high-income research ecosystems?
Methods: This review analyzed ClinicalTrial.gov records up to Mach 2026, evaluating digital trail components across Africa (268 trials) and United states (4,540 trials) through keyword searches for wearable, virtual and decentralized trial elements. Investigators reported the digital adoption rate as primary indicator of technological readiness.
Results: The findings showed that only 1.1% of rate in Africa included digital features which was 17 times lower compared to the rate of United states, suggesting continued dependence on traditional site-based research approach. The shift towards mobile and wearable technologies in Europe during the Covid-19 period appears to have widened this gap [1] from estimated ten-fold to seventen-fold between 2019 and 2025.
Interpretation: African patients risk exclusion from the next generation of decentralized clinical innovation if this gap is not addressed [2,3]. These findings quantify the bio-digital divide as a measurable infrastructure deficit. The interpretation is limited by the lack of evolving terminology of digital trial components
Note Block
Dashboard Results: https://mahmood726-cyber.github.io/africa-e156-students/health-disease/dashboards/digital-transformation.html
References
References
1. Izmailova ES, Ellis R, Benko C. Remote Monitoring in Clinical Trials During the COVID-19 Pandemic. Clinical and Translational Science. 2020;13(5):838–41.
2. Nebie EI, Sawadogo HN, Eeuwijk P van, Signorell A, Reus E, Utzinger J, Burri C. Opportunities and challenges for decentralised clinical trials in sub-Saharan Africa: a qualitative study. 2023;
3. Ejigu DA, Fekadu A, Makonnen E, Hervé J, Eaton N, Conradie A, Liebenberg C, Demarest H, Croucher K, Manyazewal T. Assessing the adoption and impact of decentralized clinical trial approaches in Africa: a multi-country survey. 2026;
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2026 PETER EBOT EYONG, Jacob Muruhukye, Rita Ewah Mbah, Endurance Lum Ambe, Vahid Esangaya Ntoung-Mbi , Spritney Nashua Ninpa , Tata Liza Ting, Rhoda Chikula, Grace Kemigisha , Geofrey Emesu , Ronald Bwambale , Janepher Nabaasa , Ebere Olive Nwanja, Prossy Nabateregga , Gloria Margaret Nanono