Randomised trials of COVID-19 vaccines in Africa – charting the path forward

Wiysonge, Charles Shey; Ndwandwe, Duduzile; Mathebula, Lindi; Goga, Ameena Ebrahim; Gray, Glenda

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dc.contributor.author	Wiysonge, Charles Shey
dc.contributor.author	Ndwandwe, Duduzile
dc.contributor.author	Mathebula, Lindi
dc.contributor.author	Goga, Ameena Ebrahim
dc.contributor.author	Gray, Glenda
dc.date.accessioned	2022-06-08T05:40:06Z
dc.date.available	2022-06-08T05:40:06Z
dc.date.issued	2022-05
dc.description.department	Paediatrics and Child Health	en_US
dc.description.librarian	hj2022	en_US
dc.description.sponsorship	Vaccines have played a critical role in controlling disease outbreaks, hence the proliferation of the development and testing of multiple vaccine candidates during the COVID-19 pandemic. Randomised trials are gold standards for evaluating the safety and efficacy of pharmaceutical interventions such as COVID-19 vaccines. However, contextual differences may attenuate effects of COVID-19 vaccines. Thus, the need to conduct COVID-19 vaccine trials in all settings, including in Africa. We conducted a crosssectional analysis of planned, ongoing, and completed COVID-19 vaccine trials in Africa. We searched the South African National Clinical Trials Register, Pan African Clinical Trials Registry, and International Clinical Trials Registry Platform (ICTRP) on 12 January and 30 April 2022; and complemented this with a search of ClinicalTrials.gov on 17 May 2022. We screened the search output and included randomised trials with at least one recruitment site in Africa. We identified only 108 eligible trials: 90 (83%) evaluating candidate COVID-19 vaccines, 11 (10%) assessing if existing vaccines could prevent SARS-CoV-2 infection, and 7 (7%) evaluating interventions for improving COVID-19 vaccination coverage. South Africa had the highest number of trials at 58 (54%). Beyond South Africa, countries with more than 10 trial sites include Kenya, Ghana, Egypt, Uganda, and Zimbabwe. Among the trials, 14 (13%) do not have principal investigators based in Africa, 39 (30%) are funded by industry, and 91 (84%) are funded by institutions based outside the host country. COVID-19 vaccine trials with recruitment sites in Africa represented only 7% of the 1453 COVID-19 vaccine trials in the ICTRP. The paucity of COVID-19 vaccine trials conducted on the African continent is a cause for concern. This has implications for the role that Africa may play in future pandemics. SIGNIFICANCE: • There are generally very few vaccine trials conducted in Africa, relative to the rest of the world. • The limited vaccine trials in Africa could be attributed to limited expertise and resources, both human and material, as well as lack of perceived market. • It is reassuring that many COVID-19 vaccines are planned, being conducted, or have been conducted in multiple African countries; but there is a need for more African public sector funding for vaccine trials on the continent.	en_US
dc.identifier.citation	Wiysonge, C.S., Ndwandwe, N., Mathebula, L., Goga, A. & Gray, G. Randomised trials of COVID-19 vaccines in Africa – charting the path forward.South African Journal of Science 2022;118(5/6), Art. #13224. https://doi.org/10.17159/sajs.2022/13224.	en_US
dc.identifier.doi	10.17159/sajs.2022/13224
dc.identifier.issn	0038-2353 (print)
dc.identifier.issn	1996-7489 (online)
dc.identifier.uri	https://repository.up.ac.za/handle/2263/85733
dc.language.iso	en	en_US
dc.publisher	Academy of Science of South Africa	en_US
dc.rights	© 2022. The Author(s). Published under a Creative Commons Attribution Licence.	en_US
dc.subject	COVID-19 vaccines	en_US
dc.subject	Africa	en_US
dc.subject	Pandemics	en_US
dc.subject	Clinical trials	en_US
dc.subject	Prospective registration	en_US
dc.title	Randomised trials of COVID-19 vaccines in Africa – charting the path forward	en_US
dc.type	Article	en_US