The clinical trials that shape modern medicine often overlook the crucial frontline services you’re most likely to use when you need healthcare – your GP surgery or local health centre. Now, an international team, led by the University of Oxford, is calling for a fundamental shift in how we conduct health research to better serve our real-world health and care needs.
In a new paper published in Lancet Global Health, a team of experts from Oxford's Nuffield Department of Primary Care Health Sciences, alongside colleagues from the University of Southampton, Stellenbosch University in South Africa, Kamuzu University of Health Sciences, Malawi, University of Zambia, The Chinese University of Hong Kong, and the World Health Organization, and other leading global partners, are making a powerful call to ‘democratise’ clinical trials.
This isn’t about politics; it’s about ensuring health research truly includes everyone, especially people who are often under-represented because of ethnicity, geography, or social circumstance¹. For example, the authors say trials should be co-designed with local communities, remove barriers like travel costs, and welcome those juggling multiple illnesses –so the resulting evidence genuinely reflects the diverse populations that most need it.
However, the authors note, achieving this vision will require firm policy commitments and funding reforms to address systemic barriers currently holding back primary care research.
Professor Christopher Butler, lead author of the report and based at the Nuffield Department of Primary Care Health Sciences, University of Oxford, explains:
“Clinical trials are the engine of progress in healthcare – they show us what works and what doesn’t, but, for too long, these trials have mainly focused on hospital settings. While this is undoubtedly important, focusing too much resource on only those kinds of trials means we’re missing crucial insights into how to improve the essential healthcare that most people rely on day-to-day in their communities.”