WHO offers roadmap for making clinical trials more inclusive

As health journalists, we're always on the lookout for developments that could reshape how medical research is conducted and reported. Changes in government policies, pharmaceutical regulations, or research methods and funding can dramatically affect how research is conducted. This in turn affects research outcomes and, ultimately, healthcare delivery.

For years, journalists like myself have reported on the stark disparities in clinical trials. In 2023, the World Health Organization (WHO) issued guidelines on how clinical trials are designed, conducted and overseen globally in an attempt to level the research field. Numbers from the report tell a troubling story: In 2022, "the number of trials registered in high income countries (27,133) was over 90 times higher than in low income countries (294)," reads the report.

View detailed WHO data on global clinical trials.

This imbalance isn't merely a statistic; it's a matter of life and death. As journalists, we've seen how this plays out in real life - drugs tested primarily on affluent populations in developed countries often fail to work effectively in diverse settings around the world. Vulnerable groups like pregnant women, children and historically marginalized people have been left out of crucial research, which can lead to ineffective treatments, patient mistrust and hesitance to accept health recommendations.

Building a better global research process

The WHO's guidance offers a roadmap for making clinical trials more inclusive, efficient, and ultimately beneficial to people worldwide. It emphasizes the need for diversity in trial participants, pushing for a broader range of people to be included in research. The guidance also highlights the importance of focusing on underrepresented groups; less than 5% of clinical trials included pregnant women in 2022, and only 13% included children, according to the agency.

But the recommendations aren't just about making trials more inclusive; it's about fundamentally changing how global health research operates. The agency, however, doesn't have much power to enforce protocols in clinical trials to implement their desired guidance. The WHO tracks clinical trials that conform to the agency's standards through its registry, but that's as far as their involvement goes.

The guidance also calls for community engagement throughout the research process. It's not just about recruiting diverse participants; it's about involving communities from the very beginning. This shift recognizes that local insights can significantly enhance the relevance and effectiveness of health interventions.

Another crucial aspect is the emphasis on strengthening local research capabilities in low- and middle-income countries. Many of these countries struggle with limited research facilities, trained staff, lab equipment, and technology needed to conduct clinical trials effectively.

The WHO wants to build up these nations' research infrastructures rather than simply using them as data sources for wealthier nations.

If ever implemented, this approach could lead to more equitable health solutions that genuinely address global health challenges.For us as health journalists, this guidance opens up new avenues to explore in our reporting. We can ask tougher questions about participant diversity in the trials we cover and seek stories about how local communities are being involved in research planning.

There's also an opportunity to investigate how countries are building their research infrastructure and whether new drugs and treatments are being tested in populations that reflect real-world diversity. As we report on new medical breakthroughs moving forward, we now have a framework to assess whether they truly serve global needs. And, of course, attribute the source.

WHO data on global clinical trials