TY - JOUR T1 - Unseen and unheard: African children with cancer are consistently excluded from clinical trials JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2020-004750 VL - 6 IS - 1 SP - e004750 AU - Emmanuella Amoako AU - Desmond Tanko Jumbam AU - Yaw Bediako Y1 - 2021/01/01 UR - http://gh.bmj.com/content/6/1/e004750.abstract N2 - Cancer in Africa has been described as a runaway train as it now kills more Africans than malaria.1 2 There are an estimated 1 million new cases of cancer on the continent every year and this is expected to double by 2030.3 Cancer in Africa is characterised by high mortality and the disparity between mortality rates in Africa and high-income countries (HIC) is most striking for childhood cancers with mortality rates as high as 80% compared with 20% in HICs like the USA and Canada.4 Despite the stark disparity in burden (85% of childhood cancers occur in low and middle-income countries5) and mortality rates of childhood cancers in Africa, access to clinical trials, which are vital for the development of effective and safe therapeutics and treatment, remains unacceptably low for African children.Over the last two decades, clinical trials have played a key role in improving survival rates for children with cancer in HICs.6 For example, in England, patients with cancer enrolled in clinical trials have significantly higher survival rates than similar patients with cancer who are not enrolled in trials.7 The National Comprehensive Cancer Network has stated that clinical trials are the best way to manage patients with cancer.2 8 Unfortunately, this is not possible for most African countries where very poor prognosis has been linked to late presentation, malnutrition, treatment abandonment, lack of proper supportive services and need for drug dose … ER -