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International Clinical Trials

MENA Reality

Research points to the market potential for clinical trials lying in the Middle East and North Africa (MENA) and other emerging markets, where pharma companies can improve local healthcare and make cost savings. But what about the reality?

Over the last decade, the concept of corporate social responsibility has gained ground among big multinationals in different industry sectors – oil and gas, telecoms, food and drink, and of course pharma. This responsibility involves the company contributing to the wealth, wellbeing, sustainable growth and development of local communities. It is a concept that has driven a substantial amount of pharma activity in emerging markets in a bid to improve the healthcare systems there and to help companies benefit from potential cost savings and efficiencies.

That said, progress in developing some aspects of clinical trials in developing regions has been limited. Activities such as late phase clinical development, study data management, clinical trials supplies, electronic patient records and outcomes studies are widely implemented in North America and Europe as a result of decades of continuous improvement by pharma giants and CROs. However, this activity is still very restricted in emerging areas such as the MENA region and Latin America, despite the availability of high-calibre investigators, qualified engineers, biostatisticians and technicians, modern telecoms infrastructure and encouraging regulatory systems.

Growth Areas

Although the global economy is continuing to recover from recession, growth in pharma activity – particularly clinical trials – is still possible in emerging markets, even those that have seen recent social and political changes. In Tunisia, for example, a large number of young graduates possess diplomas and other qualifications in life sciences, new media, communication technologies, statistics, pharmacy, biology and engineering that can be tapped into. Yet, a high proportion of these graduates – in some cases, up to 20 per cent – face unemployment due to lack of work opportunities. At the same time, infrastructures such as 20Mb/s ADSL lines and 3G+ network coverage are spreading throughout countries in the MENA region, and investors are looking to establish related businesses in tax-free zones.

Market Potential

Many industry reports point to the future of the clinical research industry lying in the MENA region, as well as the Russian Commonwealth of Independent States and Latin America. Moreover, it is predicted that emerging markets will represent one-third of global drug expenditures by 2015 (1).

In the Asian region, a group of major pharma companies has come together under the PanAsian Clinical Research Association to form the Asian Training Consortium. It aims to raise the quality of clinical development operations, maintain an effective and current training for intervenients, and ensure cost effectiveness by sharing training burden between member companies. Initiatives such as this are a model for what needs to be implemented in the MENA region, and will help leverage clinical studies activity in the area.

Embracing corporate social responsibility, large pharma companies are generating change-driven sustainable growth in our society. Shifting late phase R&D to the MENA region is accelerating in pace, with pharma leaders aware of the benefi ts to CROs and the quicker time to markets, without breaches to ethics and safety. Countries such as Tunisia offer the industry real potential in terms of unmet medical needs among the population, performing investigators and technology infrastructure. Business operations in such emerging markets permit sharing of benefits and knowledge among stakeholders, more qualified and trained personnel, significant added value to the health system, and cost effectiveness in project management.


1. Ormesher D, Search for growth by embracing emerging markets, Vice President, Business Development & Operations, Emerging Markets, Quintiles, November 2012, visit:

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Chiheb Guerfel has more than eight years of clinical practice experience in Europe and North Africa in the fields of occupational medicine, remote medicine and community based health. During this time he implemented several epidemiological projects for a wide range of sponsors, and occupied a number of positions in the local pharma industry. At Poseidon Pharma Services, he is involved in widening local and regional interest in clinical research and pushing towards excellence in GCPs among the medical public.
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