Research funders: Driving reforms in global clinical trials
Through a joint statement, some of the world’s largest funders of medical research have agreed on implementing WHO standards that will promote clinical trial integration within sustained national clinical trial infrastructure. The standards also promote clinical trials that are well-designed, answer unmet needs and embed best practice as outlined in the WHO Guidance for Best Practices for Clinical Trials. Major focus areas include patient involvement and community and public engagement, representativeness of trial populations and research transparency.
Why funders matter
Funders shape the future of health research. Every decision about what gets supported, and how, is a chance to make clinical trials more impactful, inclusive, and equitable. Clinical trials are essential to generate reliable evidence that guides policies, strengthens health systems, and improves lives. Yet too often, trials have not been driven by local needs, or infrastructure established has not been sustained nor is relevant to the local health system, leading to wasted resources and missed opportunities to improve health and socioeconomic development.
The WHO Guidance for Best Practices for Clinical Trials calls for funders to play a pivotal role in addressing these challenges. By supporting well-designed trials that answer relevant public health questions, investing in long-term infrastructure, and fostering diversity in participation, funders can help create an ecosystem where every trial produces results that matter. The guidance highlights the importance of ensuring representative populations in trials, timely and transparent sharing of results, and engaging patients and communities throughout the research process.
The Global Action Plan for Clinical Trial Ecosystem Strengthening (GAP-CTS) builds on this by outlining coordinated global actions. For funders, this means moving beyond project-by-project investments to sustained and, strategic support that builds resilient trial systems—systems that can pivot in times of emergency, reach under-represented populations, and translate discoveries into equitable health gains.
By following this roadmap, funders can reduce waste, promote equity, and ensure that evidence from trials is both scientifically robust and socially relevant. In doing so, they help deliver on the promise of clinical research; faster, fairer access to safe and effective health innovations for all.
Funders taking action
In joint statements (2025 and 2017), funders are proactively setting standards for accountability, transparency, and patient involvement. The WHO Guidance gives concrete recommendations to guide funders in this journey.
Recommendations for funders (from WHO Guidance for Best Practices for Clinical Trials)
1. Create an enabling environment
Funders should work with authorities and researchers to foster public engagement, reduce unnecessary bureaucracy, and strengthen accountability and transparency.
- Facilitate public understanding of the value of research, including clinical trials.
- Disclose conflicts of interest and support capacity building for financial and management systems.
2. Build research infrastructure and capacity
Funders play a key role in strengthening trial systems by investing in networks and infrastructure.
- Collaborate with regulators, researchers, and Member States to establish or sustain clinical research networks.
- Invest in laboratory infrastructure, sample storage, and staff capacity to support trials, particularly in low-resource settings.
3. Protect research participants
Funders must ensure that adequate resources are available to uphold ethical standards.
- Allocate funds for training on scientific and ethical considerations.
- Support time and resources for clear, accessible consent and communication processes, including innovative approaches.
4. Avoid exploitative research
Research should reflect local priorities and promote equitable partnerships.
- Involve local bodies, patients, and the public in setting priorities.
- Oppose double standards in research and support long-term equitable partnerships between low- and middle-income countries (LMICs) and high-income countries (HICs).
5. Strengthen ethical review and capacity
Funders can help build resilient and responsive ethics review systems.
- Invest in capacity building for Research Ethics Committees (RECs), especially in resource-limited settings.
- Support training, expedited reviews, proportionate risk-based monitoring, and provide materials in languages beyond English.
6. Design research responsively
Trials should be designed to meet real-world health needs and ensure inclusive participation.
- Recognize the importance of understanding study populations to assess impact.
- Support research that includes children, women (including pregnant and lactating women), and other groups often excluded without justification.
- Invest in education on methodology and trial design in resource-limited settings.
7. Share information responsibly
Funders should ensure that data and results are accessible, timely, and reliable.
- Include funding for data-related activities in grants.
- Support staff costs for communicating results to participants, communities, clinicians, policymakers, media, and the public.
8. Include underrepresented populations
Funders should ensure that all populations who may benefit from interventions are represented in trials.
- Support research addressing the needs of women of child-bearing age, including pregnant and lactating women.
- Strengthen regulatory and academic capacity for paediatric and geriatric trials.
- Expand clinical trial capacity for elderly and very elderly populations.
Over the past decade, funders have demonstrated growing leadership in strengthening clinical trials. Through collective statements, they have set common standards, aligned their policies, and committed to more open, inclusive, and effective research practices. These milestones show how funders are moving from principle to practice, and from transparency alone to a broader vision of ecosystem strengthening.
- 2025 joint statement on strengthening clinical trials
Funders expanded their commitments to cover the full trial ecosystem, supporting infrastructure, inclusivity, and resilience so that trials deliver reliable evidence for all.
- 2017 joint statement on public disclosure of results from clinical trials
Funders pledged to ensure that every trial they support makes its results public, tackling research waste and building trust through transparency.
Together, these statements show how funders are turning the vision of World Health Assembly resolution 75.8 (WHA75.8) on strengthening clinical trials and WHO guidance into action, moving from commitments on transparency in 2017, to a full ecosystem approach in 2025.