Clinical Trials and Therapeutic Approaches for Healthcare Challenges in Pakistan

Abstract

Pakistan faces tremendous challenges in providing healthcare due to a lack of consistent policymaking, increasing expenditure and exponential growth in population since its inception in 1947. These challenges are not just driven by politics, policy and allocation of resources but also by healthcare, environment and characteristics of the population biology. Clinical trials provide the best way to find population-specific, cost-effective treatments that do not merely mimic those used in wealthier nations. This article analyzes all clinical studies conducted with at least one site in Pakistan listed on ClinicalTrials.gov, combined with a short overview that considers new therapeutic approaches that can be investigated in future clinical trials. Therapies using repurposed medicines are of particular interest as they use affordable drugs that are already widely available.

Keywords: Pakistan; health facilities; healthcare costs.

Figure 1

Selection of studies from ClinicalTrials.gov.

Figure 2

Start date (year) of the studies. Each column is labeled with the number of studies started (or expected to start) in that year.

Figure 3

Numbers of participants (enrolment) in the studies. One study had an enrolment of 5,000,000 participants (NCT04184544). Two studies did not state the enrolment (NCT00327574 and NCT00198601).

Figure 4

Data source (www.sbp.org, accessed on 31 August 2023) [9] for expenditure and World Bank for population growth [2]); World Bank sourced data from www.macrotrends.net accessed on 31 August 2023 for the GDP. For this figure, we consider 1 million = 1 × 10⁶, 1 billion = 1 × 10⁹ and 1 trillion = 1 × 10¹².