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360 Olatunji et al. | Journal of Clinical and Translational Research 2023; 9(5): 357-368
a stark disparity underscores the significant funding gap that the consent procedures, and data collection efforts [33]. Cultural
continent faces. beliefs, traditions, and stigmas also influence the willingness of
Furthermore, ethical and regulatory challenges pose significant individuals to participate in clinical studies [35].
implications for clinical and translational research in Africa, Brain drain and limited research capacity present significant
affecting the conduct of studies involving human subjects [6]. obstacles to clinical and translational research in Africa.
Establishing and maintaining strong ethical guidelines and Disturbingly, Africa’s contribution to the world’s scientific output
regulatory frameworks are paramount to safeguarding the rights, has dwindled from 0.5% to a mere 0.3%, reflecting the region’s
welfare, and safety of research participants while upholding the struggles in retaining scientific talent [36]. The continent is
integrity of research data. However, implementing and enforcing grappling with a continuous brain drain of scientists, engineers,
these standards vary significantly across African countries, leading and technologists, further exacerbating the research capacity gap.
to inconsistencies, delays, and ethical dilemmas [29]. Establishing Africa accounts for only 3.6% of the world’s scientific workforce,
and maintaining strong ethical guidelines and regulatory indicating a severe shortage of research professionals [36].
frameworks are crucial to protect research participants’ rights, The overwhelming concentration of 80% of scientific research
welfare, and safety of research participants and ensuring the data’s in a handful of industrialized countries underscores the stark
integrity. However, implementing and enforcing these standards disparity in research capabilities worldwide [36]. This disparity
can vary across African countries, leading to inconsistencies, is particularly acute in sub-Saharan Africa, where the migration
delays, and ethical dilemmas [29]. One example of such challenges of young and educated professionals significantly affects an
is the variation in ethical review processes [6]. Countries often have already scarce pool of human capital [37]. The departure of skilled
different procedures for reviewing research protocols, obtaining individuals from the region robs Africa of much-needed expertise,
informed consent from participants, and ensuring the ethical hindering the establishment and growth of research initiatives
conduct of studies [6]. This inconsistency can create confusion and and institutions. This brain drain phenomenon significantly
hinder the timely initiation of research projects. impairs Africa’s capacity to conduct clinical and translational
One prominent challenge in research ethics governance is the research at the level needed to effectively address the continent’s
historical context of its development [29]. Research governance diverse health-care challenges. Losing talent to more developed
structures have often been a reactive response to past unethical regions denies Africa the expertise required to innovate, develop
research practices [30]. Despite increased research activity in context-specific solutions, and drive scientific advancements. The
Africa over the past decade, driven by pressing psychosocial and departure of skilled researchers and health-care professionals from
health-related challenges, improvements in the governance and the continent seeking improved opportunities and resources has
oversight of human research practices have yet to be commensurate significant consequences. This ongoing exodus results in a loss of
with this growth [31]. This has, unfortunately, created a window valuable expertise, leading to a weakened research capacity that
for exploitative research funded by resource-rich countries, impedes Africa’s ability to effectively address its communities’
conducting studies in Africa that might be considered unethical in unique health challenges.
countries with more established and stringent research regulatory The critical deficit of scientists and researchers in Africa is
frameworks. a pressing concern that requires urgent attention. The need for
In some cases, lengthy review processes can delay the start of
studies, affecting the ability to address urgent health concerns or more skilled professionals directly affects the region’s ability to
conduct impactful research and develop innovative solutions to
introduce new interventions. The availability and accessibility address the specific health needs of its diverse populations. With
of research ethics committees (REC) often differ across African a sufficient pool of researchers, the ability to generate locally
countries [32]. Some regions may need more resources and
infrastructure to establish and maintain RECs, which can delay the relevant evidence and implement context-specific interventions
approval of research projects [32]. This situation can hinder the is greatly improved. The consequences of this brain drain are
progress of studies and discourage researchers from conducting far-reaching. The loss of talented individuals deprives African
research in those areas. In addition to the challenges related to countries of the intellectual capital needed to advance clinical
ethical review processes, there are disparities in the understanding and translational research and hampers the overall progress of
and applying ethical principles and guidelines among researchers, the health-care system. The absence of skilled researchers and
health-care providers, and participants [32]. Cultural beliefs, health-care professionals diminishes the quality of care provided,
language barriers, and limited awareness of research ethics can reduces the capacity for scientific discoveries, and undermines the
influence participants’ understanding of the risks and benefits development of effective health policies and interventions tailored
of participating in studies [33,34]. This lack of understanding to the local context.
impacts the validity and quality of informed consent, potentially 4. Policy Recommendations and Future Directions
compromising participant autonomy and the reliability of research
findings. Similarly, linguistic and cultural barriers also challenge Improving the health infrastructure in Africa is crucial to
clinical and translational research in Africa [33]. The continent is meet the demands of clinical and translational research on the
characterized by linguistic diversity and cultural variations, which continent. Adequate health infrastructure, including hospitals,
inhibit effective communication, participant recruitment, informed clinics, laboratories, and specialized care facilities, is essential to
DOI: http://dx.doi.org/10.18053/jctres.09.202305.23-00079