Strengthening hepatitis B virus clinical research in Africa: the need for multistakeholder collaboration, funding, and political will

Africa bears a disproportionate burden of hepatitis B virus (HBV) infection, with 68 million chronically infected individuals and 65% of global new infections. However, only 18 (1%) of 1804 global HBV clinical trials have been conducted in Africa, limiting the generalisability of therapeutic findings. The HBV arm of the Forum for Collaborative Research convened a series of multistakeholder discussions between 2023 and 2024, to identify gaps in clinical research and identify solutions. This Personal View synthesises insights from these convenings, highlighting key barriers and potential solutions to the disparities in HBV clinical research. Barriers include inadequate funding, insufficient political will, low community awareness, and logistical challenges due to health-care infrastructure and regulatory systems. This Personal View emphasises the urgent need for African-led research, given region-specific factors such as diverse HBV genotypes and co-infections with HIV and hepatitis D virus. We propose solutions, including strengthening regulatory frameworks, leveraging existing research networks, establishing industry funding consortiums, and advocating for increased investment.