Leveraging an epidemic to establish vaccine clinical trial capacity in a low resource setting: the Ugandan experience

Pandemics are becoming increasingly frequent, driven by global mobility, rapid urbanization, climate change, and heightened human–animal interaction. Despite experiencing a high burden of infectious disease outbreaks, Sub-Saharan Africa remains underrepresented in vaccine research and development. Most vaccines are designed, tested, and validated outside the continent, largely due to limited visibility of trial-ready sites, inadequate infrastructure, unpredictable regulatory pathways, and gaps in basic science capacity. Lessons from Uganda’s Ebola outbreak demonstrate how these systemic weaknesses delay the generation of critical evidence needed to guide outbreak response and medical countermeasure deployment.

This paper distills key insights from that experience to highlight the essential components required to establish a functional vaccine trial site in low-resource settings. These include developing trained clinical trial teams, creating adaptable generic protocols, investing in vaccine cold-chain infrastructure, strengthening south-south collaborations, enhancing national stewardship, and fostering close engagement with ethics and regulatory bodies. Building such capacity would allow African institutions not only to respond more effectively to emerging epidemics but also to participate meaningfully in global vaccine trials—ensuring that future countermeasures are informed by the populations most affected.