Barriers for conducting clinical trials in developing countries- a systematic review

Area of Science:

• Global Health
• Clinical Research
• Health Equity

Background:

• Developing countries face a high burden of communicable and non-communicable diseases.
• Under-representation in global clinical trials perpetuates health inequities.
• Barriers hinder clinical researchers in developing nations.

Purpose of the Study:

• To review literature on barriers faced by clinical researchers in developing countries.
• To identify key obstacles to conducting clinical trials in these regions.

Main Methods:

• Comprehensive literature search of major databases (PubMed, Embase, CINAHL, Web of Science, WHO Global Health Library).
• Inclusion of grey literature.
• Appraisal of relevant articles by two independent reviewers.

Main Results:

• Ten studies, reported in 15 papers, were included.
• Five major themes of barriers were identified: financial and human capacity limitations, ethical/regulatory obstacles, lack of research environment, operational challenges, and competing demands.
• Barriers exist at system, organizational, and individual levels.

Conclusions:

• Addressing barriers requires systemic changes.
• Recommends wider implementation of local investigator-initiated trials.
• Local trials are more responsive to national needs and build on local healthcare knowledge.