Insights from the STRATEGIC Symposium at the Twelfth EDCTP Forum in Kigali

As Africa continues to embrace digital transformation in healthcare and research, the ethical and legal frameworks guiding the use of such technologies remain uneven and, in many cases, underdeveloped. At the recent 12th EDCTP Forum in Kigali, the STRATEGIC project brought together experts and stakeholders to unpack these critical issues in a timely and thought-provoking symposium titled: 

"Ethical and Legal Evaluation of Digital Technologies for Clinical Trials and Research in Africa: Challenges and Opportunities for Mutual Learning." 

Chaired by Dr. Damian Eke, Assistant Professor at the School of Computer Science, University of Nottingham, UK, the symposium created a vibrant platform for discussing how digital technologies are reshaping clinical trials across the continent, the accompanying ethical dilemmas, and the legal reforms urgently needed to support this shift. 

Adriaan Kruger, representing Nuvoteq in South Africa, opened the symposium with an overview of the emerging digital tools supporting clinical trials. He demonstrated how platforms, systems and dashboards Nuvoteq is developing are already improving trial efficiency, participant reach, and data accuracy and quality. However, Kruger stressed that technology alone isn't the solution; a harmonised framework of capacity building, stakeholder trust, and responsible data use is critical to maximise their impact in African contexts. 

Following this, Dr. Thomas Nyirenda of the EDCTP Association addressed the ethical implications of deploying digital technologies in clinical research. He raised key concerns about the use of technologies in the fragile settings in Africa and the role key values of the Trust Code, such as fairness, respect, care and honesty, can play. He also highlighted the role the STRATEGIC project findings can have in building a sustainable infrastructure for socially acceptable and ethically responsible clinical research and trials in Africa.   

The final presentation by Dr. Marceline Djuidje Ngounoue, Associate Professor of Biochemistry, Molecular Biology & Immunology from the University of Yaoundé I in Cameroon, mapped the current research findings from the STRATEGIC project via practical use cases.  The findings revealed a patchwork of fragmented policies, with many countries lacking dedicated legislation or regulatory guidance on digital health. She underscored the urgency of regional collaboration, interdisciplinary research, and mutual learning between African nations and global partners to co-develop robust ethical-legal infrastructures that can keep pace with digital innovation. 

Throughout the symposium, a recurring theme emerged: mutual learning and capacity development. Rather than importing regulatory models wholesale, participants emphasised the importance of bidirectional knowledge exchange and not just between African countries, but between African and Global North institutions. This approach recognises Africa's potential to innovate ethical and legal paradigms in ways that are globally relevant and locally aligned. 

This symposium highlighted important discussions about the future of ethical and legal evaluations of digital technologies in African clinical research. As digital health continues to evolve, the key takeaway is clear: technology must be shaped by ethics, law, and equity.