TONIO: Clinical trials benefit patients, improving care for others

Wanjira Mukiri, a 52-year-old Kenyan living in the UK, was diagnosed with stage three bladder cancer. Her initial health screenings missed the mark, tying it down to menopausal symptoms based on her age. Treatment at this stage has lower efficacy levels, but a trial drug was found that would allow her some reprieve and increase her days. Unfortunately, she was too frail and passed away in less than two months. In medicine, timing is everything.

Mama Otieno was diagnosed with cancer in 2020. At the prime age of 75, she had lived her best days. With early detection, she started early treatment on chemotherapy and, after completing her cycles, returned to her normal life. In 2024, her quarterly check-up revealed a relapse of the cancer. Her doctor advised trying a new experiential drug being tested that would hopefully offer her better results.

When people hear the words clinical trial, many think of risky experiments done on people rather than for people. In reality, clinical trials are research studies done for people to test whether new treatments, like drugs, vaccines or medical devices, are safe and effective. It may involve patients, healthy people, or both. Every medicine we use today was once tested in a clinical trial before it was approved.

In Kenya, major centres such as Kemri, Moi Teaching and Referral Hospital, Aga Khan University Hospital and Kenyatta National Hospital are involved in running approved trials. These are not random experiments; they are carefully controlled and monitored medical studies that follow strict universal standards.

Patients who agree to take part in these trials often benefit from early access to promising treatments, frequent medical reviews and close monitoring throughout the studies. More importantly, they contribute to knowledge that improves care for future patients.

Participation in these trials is entirely voluntary, with patient consent and safety always coming first. However, patients are not the only ones who benefit. The trials give doctors valuable experience, improve hospitals and help pharmaceutical companies license new medicines.

Hospitals usually collaborate with pharmaceutical companies or research institutions to conduct trials. The companies provide funding and drugs, while hospitals provide the medical expertise and patient care. It’s a partnership built on science, ethics and accountability.

As an oncologist working with the Kenyatta University Teaching and Referral Hospital, we treat many patients with various types of cancer. While we do not have a trial clinic yet, we have partnered with several companies whose drugs are available on the market, offering them at subsidised cost to patients.

The latest WHO global landscape of cancer revealed that the clinical trial landscape is dominated by high-income countries and focused on pharmacological interventions, with multinational collaboration limited to only three per cent of recruiting trials. Several of the deadliest cancers, including liver, stomach, pancreas and cervical, were missing in the topmost studied cancer types, particularly in Africa and Southeast Asia.

Africa makes a great case to be at the centre of clinical trials. Her population has the greatest genetic diversity on earth, which affects how people will metabolise the drugs, respond to treatment and even experience side effects. If it works in Africa, it will surely work anywhere.  Studying unique cancers and their response to treatment on the continent helps develop targeted prevention, diagnosis and treatment strategies. Further, investing in Africa promotes fair representation and ethical inclusion.

The International Cancer Foundation is seeking to change some of these statistics by offering research fellowship opportunities for doctors like me from the African continent. This August, I began my clinical research fellowship at The Christie NHS in Manchester, one of the world's largest cancer research centres.

From my training in Manchester, I  have seen how clinical trials are woven into routine cancer care. Patients are offered trials not as experiments, but as opportunities to receive the best care while helping discover better treatments.

Kenya is already making strides in this direction, but public understanding and trust remain key. I am hoping that at the end of my year here, I will be in a better position to create a case for the establishment of a clinical trial centre at KUTTRH to expand access for our patients.

Clinical trials are not about playing with lives; they are about saving them through safe, well-regulated research. Supporting ethical, locally run trials makes our health system stronger and brings new treatments closer to home.

Kenyan oncologist currently based in Manchester, UK