The Landscape of Non-Communicable Disease (NCD) Clinical Trials in Africa

Growing recognition of NCDs as a major threat to health and development in Africa has generated increasing interest in strengthening research systems capable of producing locally relevant evidence. However, effective investment and policy decisions require a comprehensive understanding of the existing evidence landscape. Although previous reviews have examined specific diseases, intervention types, or individual countries, no known review has comprehensively mapped the breadth of NCD clinical trials conducted across Africa while simultaneously examining trial distribution, leadership patterns, research capacity, implementation experiences, methodological innovations, health-system influences, and opportunities for investigator-initiated research. This gap is particularly important because the success of future NCD control efforts will depend not only on identifying effective interventions but also on understanding how such interventions can be implemented, adapted, scaled, and sustained within real-world African health systems. Furthermore, increasing calls for equitable global health research partnerships and decolonization of research highlight the need to better understand patterns of authorship, leadership, funding, and local ownership within African clinical research. A comprehensive mapping of NCD clinical trials conducted across Africa focusing on cardiovascular diseases, diabetes, cancers, chronic respiratory diseases is therefore timely and necessary. Such a synthesis can provide critical insights into existing research capacities, geographical and institutional disparities, methodological innovations, implementation experiences, and opportunities for strengthening sustainable African-led clinical trial platforms. Understanding these factors is essential for informing research investment, guiding policy, supporting capacity strengthening initiatives, and accelerating the development of locally led, context-responsive clinical research capable of addressing Africa's rapidly growing NCD burden.