Pediatric Oncology Clinical Trials and Collaborative Research in Africa: Current Landscape and Future Perspectives
By mid-2019, the population of African children age < 15 years was > 535.1 million, 41% of the total population. Although infectious diseases, malnutrition, and neonatal deaths are the main causes of childhood mortality on the continent, noncommunicable diseases such as childhood cancer are becoming increasingly important, with 100,000 new diagnoses per year. These figures originate in a context were only 57% of childhood cancer cases are diagnosed. The overall survival for childhood malignancies is poor: North Africa reports survival rates of 30.3% for all malignancies, and Southern Africa, West Africa, and East Africa report 21.7%, 8.5%, and 8.1%, respectively.
The main barriers to adequate childhood cancer care in Africa include low socioeconomic status, underdiagnosis, under-reporting, understaffing, inadequate clinical care, and a paucity of high-quality research. Clinical trials facilitate the creation of evidence to guide clinical interventions and improve overall care on many levels: They represent a critical link between scientific innovation and improvements in health care delivery. Prospective clinical trials may improve diagnostic accuracy, decrease treatment failure, and improve efficacy of specific interventions. Furthermore, they may assist in building capacity and consistency of clinical care in a multidisciplinary setting, improve facilities, and fund treatment and support costs for patients. The ability to parti