Table 4.

Recommendations to close geographic gaps in randomized controlled trial leadership and collaborations

Recommendations for LMICs  • Adopt international standards of clinical trial regulatory framework  • Enhance and restructure the medical curriculum in universities to include clinical research syllabus for undergraduate and graduate studies  • Create durable local research capacity, including sustainable research networks—clinical investigation centres, biobanks, and core laboratories  • Implement e-Health, starting with electronic medical records  • Prioritize engagement in trials that have objectives best aligned with local burden of diseases  • Incentivize investments from international pharmaceutical and biotech companies that would develop the clinical research culture and infrastructure  • Earmark funding sources dedicated to clinical research capacity building and granting local priority research programmes  • Create a favourable environment for local contract research organizations (CROs) and academic CRO operations
Recommendations for professional societies  • Include researchers from LMICs in position statements, guidelines, and policy documents  • Increase opportunities and research funding allocation to foster the growth and development of future human capital  • Increased participation in research training opportunities and exchange programmes in high-income countries  • Waive publication and conference fees for trialists from LMICs who present results
Recommendations for industry sponsors  • Rely on open processes and objective criteria to select trial leaders  • Require that trials conducted in LMICs include local investigators as collaborators and co-authors  • Invest in building research infrastructure in LMICs
Recommendations for research teams in Europe and North America  • Engage in more frequent international collaborations on research  • Expand recruitment sites to enrol patients outside Europe and North America  • Include local researchers in meaningful collaboration and authorship when conducting trials outside Europe and North America  • Increase research capacity building activities in LMICs through○ Local training programmes○ Advanced degree programmes that favour applicants from LMICs○ Research fellowships for visiting scholars○ Web-based research education programmes

LMICs, low- and middle-income countries.