Precision Medicine in Africa: A Systematic Review of Epilepsy Treatment Gap

Abstract

When I look at African health research, I can’t help but question whether the distribution of epilepsy trials across countries reveals a real research gap. Defined as the proportion of people with active epilepsy not receiving appropriate treatment, over 75% in low-income countries and over 50% in most middle-income countries, World Health Organization (WHO) and International League Against Epilepsy (ILAE) reports. Highlighting  gaps from poor health infrastructure, lack of medication, stigma, and poverty. The cross-sectional audit evaluated 23,873 African and 190,644 United States interventional trials registered on ClinicalTraials.gov through April 2026. Africa hosted 73 epilepsy trials (0.3% of its portfolio) compared to 1,017 in the United States, yielding a 0.0-fold disparity in per-population investment. Temporal analysis shows 17.1-fold growth in African trial registrations from 2000-2005 to 2021-2025, though the gap with high-income regions continues. Interpretation is limited by using a single registry and the absence of non-English trial databases.