Uganda is gaining recognition as a prominent destination for clinical trials in Africa, enhancing its appeal to global pharmaceutical companies looking to invest in medicine. The Access to Medicine Foundation has identified Uganda as one of the few African countries with the capacity to conduct clinical trials, alongside South Africa, Ethiopia, and Nigeria.
Landmark HIV Prevention Trials
Uganda has been the site of significant clinical trials, including Gilead’s trials for lenacapavir, a long-acting injectable for HIV prevention. These trials, conducted under the purpose-one program, demonstrated 100% efficacy in preventing HIV infections among women. The study enrolled over 5,300 participants across 25 sites in South Africa and three sites in Uganda, comparing the safety and efficacy of twice-yearly lenacapavir injections to daily oral descovy and truvada. The results showed zero infections among women receiving lenacapavir, surpassing the efficacy of both descovy and truvada. An independent data monitoring committee recommended stopping the blinded phase of the trial and offering open-label lenacapavir to all participants. Gilead is planning to file for regulatory approval of lenacapavir for HIV prevention, pending the results of additional trials.
Contributions to Antimalarial Development
Uganda is also actively involved in the development of new antimalarials through the PAMAfrica consortium, in partnership with Merck KGaA and Novartis. These trials are part of a broader international research effort aimed at developing new treatments for malaria, including severe and uncomplicated cases, as well as drug-resistant strains. The PAMAfrica consortium is conducting three clinical trials focusing on new combinations of compounds for treating uncomplicated malaria, a rapid-acting treatment for severe malaria, and a novel formulation for newborn infants weighing less than 5kg.
Expert Perspectives
Prof. Pontiano Kaleebu, the director of Uganda Virus Research Institute (UVRI), emphasized Uganda's progress in conducting phase one, phase two, and phase three clinical trials. He noted the historical significance of these trials, with Ugandan clinicians and scientists participating in testing the efficacy, toxicity, and modes of delivery of various drugs. Kaleebu also highlighted the groundbreaking studies on people with tuberculosis and HIV, which have contributed to the management of septrin use. He added that HIV research has significantly improved institutional and national regulations for conducting studies at the highest level.
Addressing Global Health Disparities
The 2024 Access to Medicine Index study highlights that low-income countries often struggle to attract pharmaceutical investments due to the limited capacity to conduct clinical trials. The index calls for an urgent need to reach routinely overlooked populations and encourages more companies to adopt inclusive business models that prioritize low-income and least-developed countries. The report indicates that only a few companies, including Bristol Myers Squibb, Novartis, Novo Nordisk, Pfizer, and Sanofi, have launched models that facilitate access to their products across numerous low-income countries.
