International Clinical Trials in Latin American and Caribbean Countries: Research and Development to Meet Local Health Needs

Abstract

Introduction: Although international health research involves some benefits for the host countries, such as access to innovative treatments, the research itself may not be aligned with their communities' actual health needs.Objective: To map the global landscape of clinical trials run in Latin American and Caribbean countries and discuss the addressing of local health needs in the agenda of international clinical trials.Methods: The present study is a cross-sectional overview and used data referent to studies registered between 01/01/2014 and 12/31/2014 in the World Health Organization's (WHO) International Clinical Trials Registry Platform (ICTRP).Results: Non-communicable diseases such as diabetes, cancer, and asthma—studies which were financed mainly by industries—were the conditions investigated most in the region of Latin America and the Caribbean. The neglected diseases, on the other hand, such as Chagas disease, and dengue, made up 1% of the total number of studies. Hospitals and nonprofit nongovernmental organizations prioritize resources for investigating new drugs for neglected diseases, such as Chagas disease and dengue.Conclusion: The international multicenter clinical trials for investigating new drugs are aligned with the health needs of the region of Latin America and the Caribbean, when one considers the burden resulting from the non-communicable diseases in this region. However, the transmissible diseases, such as tuberculosis and AIDS, and the neglected diseases, such as Chagas disease and dengue, which have an important impact on public health in this region, continue to arouse little interest among the institutions which finance the clinical trials.

Estado de la bio�tica e investigaci�n cl�nica en Ecuador y otros pa�ses de Latinoam�rica

“…Por último, es importante considerar la brecha 10/90 en la investigación médica, la cual se refiere a que únicamente el 10% de la financiación anual para la investigación en salud se dirige a las necesidades de salud del 90% de la población mundial más pobre; mientras que el 90% restante se concentra en los problemas de salud del 10% de la población mundial más adinerada 22,26 . Latinoamérica se encuentra entre las regiones más afectadas por las enfermedades desatendidas, como el dengue, la rabia, la esquistosomiasis y la enfermedad de Chagas; estas condiciones se denominan desatendidas porque afectan a poblaciones pobres y, por lo tanto, son poco atractivas para las instituciones que financian la investigación de nuevos medicamentos [27][28][29] .…”

Investigación científica prioritaria en Latinoamérica para orientar la prevención y el control de la COVID-19

“…Un estudio publicado en el 2018 indicaba que, aunque las capacidades de ensayos clínicos en Latinoamérica habían aumentado en los últimos años, dicho aumento había ocurrido principalmente en el campo de las enfermedades crónicas, en tanto que para las infecciosas y desatendidas solo había sido del 1 % del total, lo que evidenciaba una discordancia entre la carga de la enfermedad y las capacidades de investigación en este campo (13). El apuntalamiento de las capacidades para desarrollar ensayos clínicos y comunitarios en enfermedades infecciosas pasa por fortalecer la formación en investigación clínica, biobancos y comités científicos y de ética en regiones apartadas, con el fin de propiciar la inclusión de la población pobre, diversa y rural.…”

Overview and future challenges of nearly zero energy buildings (nZEB) design in Southern Europe

“…These technologies and materials must respond to the requirements of the nZEB and satisfy the nZEB market demand. In most Mediterranean countries, there are barriers regarding the know-how of professionals and the number of architects and engineers that are able to deal with new technologies and standards [38]. For example, the Passive-On [39,40] project published a guideline for designing and construction of Passive Houses in Southern Europe and considered the construction quality a serious challenge.…”

“…• The nZEB integrated project delivery approach and the knowledge of the exigencies of designing a nZEB is not common for architects and engineers in Portugal which will lead in many cases to inefficient solutions, non-optimized buildings and higher costs due to extra measures for integration of energy efficiency measures and renewable energy systems [68].…”