Racial Disproportionality in Clinical Trials and the Need to Rebuild Trust

November 24, 2020

// By Ndome Yvonne Essoka //

Black people account for 21 percent of deaths from COVID-19, yet they make up only 13 percent of the U.S. population. As researchers move forward with vaccine clinical trials, low participation among Black people — just 3 percent, according to the New England Journal of Medicine — is cause for concern.

In the U.S., Black people experience the highest COVID-19 mortality rates nationwide. Black people are 3.2 times more likely than White people to die from COVID-19. If the mortality rates were similar, 21,800 Black people would still be alive today. As the nation grapples with the devastating impact of COVID-19, the race for a vaccine is more important than ever, but there is huge racial disproportionality in clinical trials.

In the latest clinical trial for Remdesivir — hailed by the Food and Drug Administration as the standard for COVID-19 care — data supporting the drug’s efficacy and safety in minority groups was limited. Black people accounted for only 20 percent of patients who participated in the placebo-controlled Adaptive COVID-19 Treatment Trial (ACTT-1), and only 11 percent of the 397 patients who were randomly assigned Remdesivir in the Gilead-funded study (GS-U.S.-540-5773).

Why is there such low participation in clinical trials among Black people?

Deep Skepticism Rooted in History

Black people have a deep-seated and well-founded mistrust of the medical system that dates back to slavery. Many unethical medical experiments and clinical trials were sponsored by private organizations/actors, and unfortunately, many were also approved and sanctioned by the U.S. government. Black people are skeptical about joining clinical trials.

The most infamous and well-known example of this is the Tuskegee experiment.

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