Contributed Commentary by Marieme Ba, CEO of Pharmalys 

March 28, 2025 | When I started my career as a clinical research professional, I quickly realised that apart from South Africa, the African continent was almost entirely absent from this field. More often than not, I was the only African involved in my international projects. The study protocols I worked on referenced continents—except Africa. In fact, South Africa, Australia, and New Zealand were grouped in a single category called “Rest of the World”. Other African countries were occasionally included in clinical trials for infectious diseases, but for the most part, the continent was overlooked.  

I often asked myself: why is Africa not represented? That question marked a turning point in my career. It planted the seed for what would later become my mission—to take everything I had learned back to Africa and contribute to change.  

In 2012, I took the natural step of establishing a second company in Senegal, dedicated to building local resources so that Africa could benefit from health research outcomes designed for its population. 

The African Context 

Currently, less than 2% of global clinical trials are conducted in Africa. Yet, as efforts to expand clinical research in sub-Saharan Africa continue to gain momentum, I see a growing imperative to strengthen the clinical research ecosystem. This means reinforcing pharmacovigilance systems, enhancing the capacity of ethics committees and regulatory bodies, and increasing the number of trained clinical research professionals. 

Through my experience leading capacity-building initiatives, I have observed that only a minority of African countries are fully equipped to regulate clinical trials effectively. It was striking to find myself delivering Good Clinical Practice (GCP) training to members of ethics committees and regulatory authorities in countries where clinical trials were already taking place. These experiences exposed significant gaps, including the absence of standard operating procedures, limited knowledge of ethical review processes for clinical trial protocols and participant information sheets, and a lack of expertise in post-approval trial inspections. 

To address these challenges, my organisation has focused on practical interventions: conducting workshops, facilitating accompanied inspections and field surveillance, developing standard operating procedures, supporting the deployment of new technologies, and fostering a culture of quality in research. 

If Africa is to conduct more clinical trials—including commercially sponsored studies—there is an urgent need to build a critical mass of qualified researchers who remain on the continent. A chronic shortage of clinical research professionals is not new to our industry, and as an employer in this field, I face the daily challenge of recruiting and retaining skilled professionals.  

As both a scientist and an employer, I know that many young science graduates struggle to find clear career pathways. For years, I have actively promoted health research as a sector offering significant job opportunities. To further this mission, in 2023, I launched Pharmalys Academy of Clinical research Excellence (PACE) with the aim of raising clinical trial standards, developing a skilled workforce, and expanding employment opportunities for young scientists. From the first PACE cohort, which concluded in 2024, I hired nine PACE graduates at Pharmalys to help meeting the growing demand for job-ready clinical research professionals. 

Addressing the Global Health Disparity 

In recent years, increasing attention has been given to the lack of diversity in clinical trials. A growing body of research highlights the underrepresentation of racial and ethnic minority groups in medical studies, underscoring the potential impact on healthcare outcomes for these populations.  

Conducting clinical trials in high-prevalence regions ensures that treatments are not solely developed for populations in high-income countries but are also tailored to the specific needs of local communities. Genetic factors, dietary habits, and environmental conditions can all influence how individuals respond to medication or therapy. Without data from African populations, treatments developed elsewhere may be less effective.  

A compelling example of this issue comes from the field of diabetology, as highlighted by Prof. Maïmouna Ndour Mbaye, Professor of Internal Medicine at the Cheikh Anta Diop University of Dakar, Director of the National Centre of Diabetology, and specialist in Public Health. In a speech she made during the PACE 2023-24 Graduation Ceremony, she explains:  

“The African population has a high degree of genetic variability, which translates into variability in the prevalence and frequency of diseases in different ethnic groups. This variability is also influenced by social and environmental factors that have to be taken into consideration. There is an unusual presentation of diabetes called ketosis-prone type 2 diabetes, that does not fit the traditional categories that have been defined by the American Diabetes Association or the International Diabetes Federation. This presentation has been observed exclusively in African populations.  

There is no specific management of this ketosis-prone type 2 diabetes, because there are not clinical trials dedicated to this specific presentation. So, diabetologists rely on recommendations and guidelines that come from Europe or America to manage these patients.” 

Her insights reinforced what I had already come to realise: insufficient representation in clinical trials is not just a scientific issue—it is an ethical one. When African populations are excluded from research, study findings become less applicable to them, limiting the ability of healthcare professionals to monitor disparities and tailor interventions effectively. This exclusion hinders efforts to achieve global health equity by limiting the ability to customise governmental, clinical, and community interventions to ensure better health outcomes for all. 

My Commitment 

I am dedicated to conducting high-quality clinical research globally, with a particular focus on sub-Saharan Africa. My goal is to strengthen both research and healthcare infrastructure, expand health programmes, and generate the evidence needed to manage health crises effectively.  

I believe that greater inclusion of diverse populations in clinical trials is essential to building a more equitable healthcare system—one where no region or population is left behind in the pursuit of better treatment outcomes. 

I am an activist: Count Africa In to the clinical research sector! 

Marieme Ba is the Founder and CEO of Pharmalys, a private Contract Research Organisation (CRO). After spending a decade working in clinical research for commercial sponsors and large CROs in Europe, she founded Pharmalys Ltd in London, UK, in 2008, and subsequently established in Senegal in 2012.  With over 25 years of experience implementing clinical trials in Europe and in Sub-Saharan Africa, Marieme is capitalising on her strong scientist and entrepreneur background to contribute to COUNT AFRICA IN, in the field of clinical research. She can be reached at marieme.ba@pharmalys.com.