Abstract
This article presents a forensic audit of 23,873 clinical trial registrations to investigate the disparity between research volume and local infrastructure investment in Africa. The analysis reveals a Gini coefficient of 0.809, indicating extreme inequality where 99.6% of trials bypass permanent technology transfer. Focusing on the Ugandan context, the study highlights that while the nation hosts 809 interventional trials with a positive performance residual of +1.43, implementation of tools like the OpenMRS SDK at district facilities such as Mukono General and Kawolo Hospital remains an afterthought. The author argues for a transition from hosting research to owning discovery through ethical funding mandates that prioritize permanent capacity building. By adopting a "build-and-stay" philosophy, the research community can ensure that national health sovereignty is preserved through the local maintenance and ownership of clinical digital infrastructure.
References
1. Sewankambo, N. K., et al. (2015). "Enabling health research capacity in Africa: the Makerere University experience." Global Health Action.
2. Lang, T. A., et al. (2023). "The Global Health Network: local leadership in clinical trials." The Lancet Global Health.
3. Wagstaff, A., et al. (1991). "On the measurement of inequality in health." Journal of Health Economics.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2026 Ronnie Ssenfuma, Michael Bosiako Antwi , Ruth Wairimu , Christine Muhumuza , Marakiya Moetlediwa, Njeodo Njongang Vigny, Fadumo Said Hassan, Philbert Ruchius, Rhoda Chikula, Amina Mohamud Fidow, Shamim Nabidda, Bruce Tukamushaba, Adrine Nyamwiza, Chikosa Kumbukani , Bitness Lyabagaga, Alice Namiiro Martha, Joy Osifo, Edith Kanyesigye, Natinael Berhane yeshanew, Justine Kirabo, Felix Awuriki Kofi, Joanitah Namatovu, Olivia Amumpaire