Biobanking across Africa: from participant-level trust to institutional trustworthiness

Building trust and maintaining participant engagement are widely recognized as requirements for sustainable biobanking. Yet efforts to achieve these goals must account for the historical, economic, geo-political and socio-cultural contexts that shape participant engagement. In Africa, biobanking has shown immense scientific and global public health value, but persistent governance challenges continue to affect participation. In this Perspective, we examine the factors that have constrained participant engagement in biobanking across Africa. We argue that trust is not simply a participant-level deficit to be corrected through increased outreach. Instead, trust and mistrust are shaped by the broader biobanking ecosystem, and by whether its institutions have demonstrated that they are worthy of public trust. Drawing on studies from across the continent, we propose strategies for how governance bodies, researchers and healthcare professionals can develop biobanking systems and frameworks that are sustainable and accountable to the public at both the national and international levels. Importantly, we identify science diplomacy as a valuable mechanism for strengthening cross-border coordination in support of more equitable, coherent and locally-governed biobanking initiatives.