Urgently seeking efficiency and sustainability of clinical trials in global health

Jay J H Park; Rebecca F Grais; Monica Taljaard; Etheldreda Nakimuli-Mpungu; Fyezah Jehan; Jean B Nachega; Nathan Ford; Denis Xavier; Andre P Kengne; Per Ashorn; Maria Eugenia Socias; Zulfiqar A Bhutta; Edward J Mills

doi:10.1016/S2214-109X(20)30539-8

Urgently seeking efficiency and sustainability of clinical trials in global health

Lancet Glob Health. 2021 May;9(5):e681-e690. doi: 10.1016/S2214-109X(20)30539-8.

Authors

Affiliations

¹ Department of Experimental Medicine, University of British Columbia, Vancouver, BC, Canada.
² Epicentre, Paris, France.
³ Clinical Epidemiology Program, Ottawa Hospital Research Institute and School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
⁴ Department of Psychiatry, Makerere University, Kampala, Uganda.
⁵ Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
⁶ Department of Medicine and Center for Infectious Diseases, Stellenbosch University, Cape Town, South Africa; Department of Epidemiology and Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Epidemiology and Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.
⁷ Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
⁸ Department of Pharmacology and Division of Clinical Research, St John's Medical College, Bangalore, India.
⁹ Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa.
¹⁰ Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
¹¹ Fundación Huésped, Buenos Aires, Argentina; British Columbia Centre for Substance Use, Vancouver, BC, Canada; Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
¹² Centre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada; Institute of Global Health and Development, and Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan.
¹³ School of Public Health, University of Rwanda, Kigali, Rwanda; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada; Cytel, Vancouver, BC, Canada. Electronic address: millsej@mcmaster.ca.

Abstract

This paper shows the scale of global health research and the context in which we frame the subsequent papers in the Series. In this Series paper, we provide a historical perspective on clinical trial research by revisiting the 1948 streptomycin trial for pulmonary tuberculosis, which was the first documented randomised clinical trial in the English language, and we discuss its close connection with global health. We describe the current state of clinical trial research globally by providing an overview of clinical trials that have been registered in the WHO International Clinical Trial Registry since 2010. We discuss challenges with current trial planning and designs that are often used in clinical trial research undertaken in low-income and middle-income countries, as an overview of the global health trials landscape. Finally, we discuss the importance of collaborative work in global health research towards generating sustainable and culturally appropriate research environments.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Anti-Bacterial Agents / therapeutic use*
Clinical Trials as Topic / methods*
Developing Countries
Global Health*
Health Services Research / methods*
Humans
Streptomycin / therapeutic use*
Tuberculosis, Pulmonary / drug therapy*

Substances

Anti-Bacterial Agents
Streptomycin

Abstract

Publication types

MeSH terms

Substances

Grants and funding