Guinea Pigs of Global Health: A Historical Analysis of Medical Experimentation and African Agency in East Africa (1900-2024)
##plugins.themes.bootstrap3.article.main##
Abstract
The interaction between Africa and the world of medical research has been marked by centuries-long exploitative dynamics. Since colonial medical expeditions through modern philanthropic health projects, the African people have been used as test subjects in medical experiments whose primary goal has been to benefit non-African populations, making Africa the world’s living laboratory. This paper traces the historical path of medical experimentation in East Africa between 1900 and 2024, arguing against accounts that blame African involvement in potentially exploitative medical trials on gullibility and exploring the structural conditions that permit further exploitation. It was thoroughly researched through a desk-based historical examination of peer-reviewed literature, institutional reports, and contemporary documentation during colonial and post-colonial times. The research utilized a chronological method to follow the changing trends of medical research relations in East Africa. The study identifies three different yet related times of medical exploitation. The colonial period (1900-1960) made Africa a testing ground, with expeditions of sleeping sickness and permanent research facilities, and interventions like arsenic-based trypanosomiasis treatments that killed or blinded 10-20% of subjects. Post-independence (1960-1990) saw the persistence of extractive research relations via inherited colonial infrastructures and Cold War medical diplomacies. The modern period (1990-2024) has witnessed an escalation of exploitation by philanthropic organizations, especially the Bill and Melinda Gates Foundation which has funded over 32 billion health programs that tend to target African populations to test experimental interventions. These patterns were evident in the COVID-19 pandemic, where Africa received only 6 percent of the total number of vaccines, yet it has 17 percent of the global population and has been heavily involved in vaccine trials. Involvement of Africans in medical research is not a sign of gullibility but rational reactions to structural vulnerabilities such as poverty, inadequate healthcare access, and poor health systems. The fact that exploitative practices persist illustrates the perpetuation of colonial-era power structures in modern global health. To resolve these inequities, radical reforms to research governance frameworks are necessary, such as increased African control over research agendas, fair benefit-sharing practices, and more effective accountability mechanisms of external research actors. Africa will remain a continent serving foreign medical interests instead of being a beneficiary of the research done on its populations without such structural reforms.
Publish Your Research in This Journal
Open Journal of Medical Research and Health Sciences welcomes original research submissions on related topics.
- Double-blind peer review
- First decision in 3–4 weeks
- DOI assigned on publication
- Open Access — free to read
##plugins.themes.bootstrap3.article.details##
References
Abdulwahab, A. A., Okafor, U. G., Adesuyi, D. S., Miranda, A. V., Yusuf, R. O., & Eliseo Lucero‐Prisno, D. (2024). The African Medicines Agency and Medicines Regulation: Progress, challenges, and recommendations. Health Care Science, 3(5), 350–359. https://doi.org/10.1002/hcs2.117
Adeyanju, G. C., Essoh, T.-A., Sidibe, A. R., Kyesi, F., & Aina, M. (2024). Human Papillomavirus Vaccination Acceleration and Introduction in Sub-Saharan Africa: A Multi-Country Cohort Analysis. Vaccines, 12(5), 489. https://doi.org/10.3390/vaccines12050489
Ahmed, S. (2017). Accountability of International NGOs: Human Rights Violations in Healthcare Provision in Developing Countries and the Effectiveness of Current Measures. Comparative Law, 22.
Alt Africa Review. (2025, August 11). Revolutionizing Family Planning or Controlling Populations? Bill Gates Foundation’s 8-Year Hormonal IUD in Africa - Alt A Review. Alt Africa Review. https://alt-africa.com/2025/08/11/revolutionizing-family-planning-or-controlling-populations-bill-gates-foundations-8-year-hormonal-iud-in-africa/
Avasthi, A., Ghosh, A., Sarkar, S., & Grover, S. (2013). Ethics in medical research: General principles with special reference to psychiatry research. Indian Journal of Psychiatry, 55(1), 86–91. https://doi.org/10.4103/0019-5545.105525
Baisley, K., Kemp, T. J., Kreimer, A. R., Basu, P., Changalucha, J., Hildesheim, A., Porras, C., Whitworth, H., Herrero, R., Lacey, C. J., Schiller, J. T., Lucas, E., Mutani, P., Dillner, J., Indangasi, J., Muwonge, R., Hayes, R. J., Pinto, L. A., & Watson-Jones, D. (2022). Comparing one dose of HPV vaccine in girls aged 9-14 years in Tanzania (DoRIS) with one dose of HPV vaccine in historical cohorts: An immunobridging analysis of a randomised controlled trial. The Lancet. Global Health, 10(10), e1485–e1493. https://doi.org/10.1016/S2214-109X(22)00306-0
BBC. (2020, April 3). Coronavirus: France racism row over doctors’ Africa testing comments. BBC News. https://www.bbc.com/news/world-europe-52151722
Berrang-Ford, L., Odiit, M., Maiso, F., Waltner-Toews, D., & McDermott, J. (2006). Sleeping sickness in Uganda: Revisiting current and historical distributions. African Health Sciences, 6(4), 223–231. https://pmc.ncbi.nlm.nih.gov/articles/PMC1832067/
Bill & Melinda Gates Foundation. (2025). Innovative Partnership to Deliver Convenient Contraceptives to up to Three Million Women. Bill & Melinda Gates Foundation. https://www.gatesfoundation.org/ideas/media-center/press-releases/2012/07/innovative-partnership-to-deliver-convenient-contraceptives-to-up-to-three-million-women
Boyd, J. S. K. (1973). Sleeping sickness. The Castellani-Bruce controversy. Notes and Records: The Royal Society Journal of the History of Science, 28(1), 93–110. https://doi.org/10.1098/rsnr.1973.0008
Brun, R., Blum, J., Chappuis, F., & Burri, C. (2010). Human African trypanosomiasis. The Lancet, 375(9709), 148–159. https://doi.org/10.1016/S0140-6736(09)60829-1
Bump, J. B. (2025). Global Health and Its Limitations: An Historical Perspective. Health Systems & Reform, 11(2), 2478681. https://doi.org/10.1080/23288604.2025.2478681
Busari, S., & Wojazer, B. (2020, April 7). French doctors’ proposal to test Covid-19 treatment in Africa slammed as ‘colonial mentality’. CNN. https://www.cnn.com/2020/04/07/africa/french-doctors-africa-covid-19-intl
Coleman, D. E. (2014). Chapter 3: The State and Civil Society in Catholic Social Teaching. In S. C. Sullivan & R. Pagnucco (Eds), A Vision of Justice: Engaging Catholic Social Teaching on the College Campus (pp. 29–54). Liturgical Press.
DeStefano, L. H., Fuentes-Afflick, E., Higginbotham, E., Woolley, M., & Yamamoto, K. (Eds). (2022). Scientific and Medical Ethics: Protecting People While Enhancing Autonomy and Justice. In Transforming Human Health: Celebrating 50 Years of Discovery and Progress (p. 26722). National Academies Press. https://doi.org/10.17226/26722
Development Reimagined. (2021, February 4). 25 African countries don’t yet have vaccine orders—Is this a problem or not? Development Reimagined. https://developmentreimagined.com/africanvaccineordersproblem/
Doyle, S. (2023). Health in African History (E. Frankema, E. Hillbom, U. Kufakurinani, & F. M. zu Selhausen, Eds; pp. 96–116). African Economic History Network. https://www.researchgate.net/publication/376477870_AEHN_Textbook_2023
DW. (2020, April 3). French doctor apologizes for ‘Africa’ coronavirus test idea. DW. https://www.dw.com/en/french-doctor-apologizes-for-africa-coronavirus-test-idea/a-53014811
Ehlers, S. (2022). 4 Medical Missions – Racial Visions: Fighting Sleeping Sickness in Colonial Africa in the Early Twentieth Century. In A. Widmer & V. Lipphardt (Eds), Health and Difference: Rendering Human Variation in Colonial Engagements (pp. 91–110). Berghahn Books. https://www.degruyterbrill.com/document/doi/10.1515/9781785332722-007/html?srsltid=AfmBOoqupLfegYFfPi9lM0Ey5WQwPogWF4SMAR2VoTx-Mnj_MOnhtH0v
Euronews. (2020, July 4). What doctors and the WHO really said about Africa and vaccine testing. Euronews. http://www.euronews.com/2020/04/07/what-french-doctors-and-the-who-really-said-about-africa-and-vaccine-testing
Farmer, P. (2004). An Anthropology of Structural Violence. Current Anthropology, 45(3), 305–325. https://doi.org/10.1086/382250
Feierman, S. (1985). Struggles for Control: The Social Roots of Health and Healing in Modern Africa. African Studies Review, 28(2/3), 73–147. https://doi.org/10.2307/524604
Fèvre, E. M., Coleman, P. G., Welburn, S. C., & Maudlin, I. (2004). Reanalyzing the 1900–1920 Sleeping Sickness Epidemic in Uganda—Volume 10, Number 4—April 2004—Emerging Infectious Diseases journal—CDC. https://doi.org/10.3201/eid1004.020626
Gates Foundation. (2025). Bill Gates to Direct Majority of $200 Billion Pledge Toward Africa’s Future. Gates Foundation. https://www.gatesfoundation.org/ideas/media-center/press-releases/2025/06/africa-health-development
Geissler, P. W., & Molyneux, C. (Eds). (2017). Evidence, Ethos and Experiment: The Anthropology and History of Medical Research in Africa. Berghahn BookS. https://doi.org/10.3167/9780857450920
Ger, N., Lugossy, A.-M., & Petrucka, P. (2024). Status of “African research and its contribution to global health research: A review and an opinion”. Discover Public Health, 21(1), 192. https://doi.org/10.1186/s12982-024-00323-6
Gerlard, G. (2025, March 27). Africa: Decolonising Western Global Health Relations With Africa Critical. The Herald. https://allafrica.com/stories/202503270394.html
Graboyes, M. (2015). The Experiment Must Continue: Medical Research and Ethics in East Africa, 1940–2014. Ohio University Press Open Access Books. https://ohioopen.library.ohio.edu/oupress/26
Headrick, D. R. (2014). Sleeping Sickness Epidemics and Colonial Responses in East and Central Africa, 1900–1940. PLOS Neglected Tropical Diseases, 8(4), e2772. https://doi.org/10.1371/journal.pntd.0002772
Hoffman, J., & Lee, C. W. (2020, October 7). ‘I Won’t Be Used as a Guinea Pig for White People’. The New York Times. https://www.nytimes.com/2020/10/07/health/coronavirus-vaccine-trials-african-americans.html
Houlihan, C. F., Baisley, K., Bravo, I. G., Kapiga, S., de Sanjosé, S., Changalucha, J., Ross, D. A., Hayes, R. J., & Watson-Jones, D. (2016). Rapid acquisition of HPV around the time of sexual debut in adolescent girls in Tanzania. International Journal of Epidemiology, 45(3), 762–773. https://doi.org/10.1093/ije/dyv367
Karanja-Chege, C. M. (2022). HPV Vaccination in Kenya: The Challenges Faced and Strategies to Increase Uptake. Frontiers in Public Health, 10, 802947. https://doi.org/10.3389/fpubh.2022.802947
Kasianenko, K., Zhu, G., Barua, U., Gyamfi, G., & Saniei, S. (2025). “My first thought was Africa”: Gates as a floating signifier in global COVID-19 philanthropy discussions on X. Social Sciences & Humanities Open, 12, 102034. https://doi.org/10.1016/j.ssaho.2025.102034
Kelly, A. (2014). Chapter 3. The Progress of the Project: Scientific Traction in the Gambia. In S. Venkatesan & T. Yarrow (Eds), Differentiating Development: Beyond an Anthropology of Critique. Berghahn Books. https://doi.org/10.3167/9780857453037
Kennedy, P. G. (2013). Clinical features, diagnosis, and treatment of human African trypanosomiasis (sleeping sickness). The Lancet Neurology, 12(2), 186–194. https://doi.org/10.1016/S1474-4422(12)70296-X
Kennedy, P. G. E., & Rodgers, J. (2019). Clinical and Neuropathogenetic Aspects of Human African Trypanosomiasis. Frontiers in Immunology, 10. https://doi.org/10.3389/fimmu.2019.00039
Kruk, M. E., Gage, A. D., Arsenault, C., Jordan, K., Leslie, H. H., Roder-DeWan, S., Adeyi, O., Barker, P., Daelmans, B., Doubova, S. V., English, M., García-Elorrio, E., Guanais, F., Gureje, O., Hirschhorn, L. R., Jiang, L., Kelley, E., Lemango, E. T., Liljestrand, J., … Pate, M. (2018). High-quality health systems in the Sustainable Development Goals era: Time for a revolution. The Lancet Global Health, 6(11), e1196–e1252. https://doi.org/10.1016/S2214-109X(18)30386-3
Kunyenje, C. A., Chirwa, G. C., Mboma, S. M., Ng’ambi, W., Mnjowe, E., Nkhoma, D., Ngwira, L. G., Chawani, M. S., Chilima, B., Mitambo, C., Crampin, A., & Mfutso-Bengo, J. (2023). COVID-19 vaccine inequity in African low-income countries. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1087662
Makoni, M. (2020). COVID-19 vaccine trials in Africa. The Lancet. Respiratory Medicine, 8(11), e79–e80. https://doi.org/10.1016/S2213-2600(20)30401-X
Mukthar, V. K., & Chirchir, I. (2025). Uptake of Human Papiloma Virus (HPV) Vaccine in Kenya: Barriers and Facilitators - A Scoping Review. East African Journal of Health and Science, 8(1), 450–464. https://doi.org/10.37284/eajhs.8.1.3002
Nash, K. (2023). The African Union and Emerging Patterns of Global Health Governance. Global Studies Quarterly, 3(3), ksad048. https://doi.org/10.1093/isagsq/ksad048
Njeru, I., Ajack, Y., Muitherero, C., Onyango, D., Musyoka, J., Onuekusi, I., Kioko, J., Muraguri, N., & Davis, R. (2016). Did the call for boycott by the catholic bishops affect the polio vaccination coverage in Kenya in 2015? A cross-sectional study. Pan African Medical Journal, 24, 1–9. https://doi.org/10.11604/pamj.2016.24.120.8986
Noko, K. (2020, April 8). Medical colonialism in Africa is not new. Al Jazeera. https://www.aljazeera.com/opinions/2020/4/8/medical-colonialism-in-africa-is-not-new
Oke, G. I., & Sibomana, O. (2025). Understanding Health Inequality, Disparity and Inequity in Africa: A Rapid Review of Concepts, Root Causes, and Strategic Solutions. Public Health Challenges, 4(1), e70040. https://doi.org/10.1002/puh2.70040
Okereke, E. (2024, April 22). Global Health and the ‘Second Independence of Africa’. Think Global Health. https://www.thinkglobalhealth.org/article/global-health-and-second-independence-africa
Okwonga, M. (2020, April 17). The French doctors who wanted to test vaccines on Africans and Western medicine’s dark history. QZ. https://qz.com/africa/1836272/french-doctors-say-test-covid-19-vaccine-on-africans-spark-fury/
Salah, M. (2024). The vital role of medical research in advancing global health. Allied Journal of Medical Research, 8(3). https://doi.org/10.35841/aaajmr-8.3.233
Sidibé, M. (2022, January 24). Vaccine inequity: Ensuring Africa is not left out. Brookings. https://www.brookings.edu/articles/vaccine-inequity-ensuring-africa-is-not-left-out/
Singh, J. A. (2020). The Case for Why Africa Should Host COVID-19 Candidate Vaccine Trials. The Journal of Infectious Diseases, 222(3), 351–355. https://doi.org/10.1093/infdis/jiaa303
Spigner, C. (2007). Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present. Journal of the National Medical Association, 99(9), 1074–1075. https://pmc.ncbi.nlm.nih.gov/articles/PMC2575876/
Spooner, S. (2015, November 18). Melinda Gates: This is how contraception is changing women’s lives. World Economic Forum. https://www.weforum.org/stories/2015/11/melinda-gates-this-is-how-contraception-is-changing-womens-lives/
Steverding, D. (2008). The history of African trypanosomiasis. Parasites & Vectors, 1, 3. https://doi.org/10.1186/1756-3305-1-3
Tilley, H. (2011). Africa as a Living Laboratory: Empire, Development, and the Problem of Scientific Knowledge, 1870-1950. University of Chicago Press. https://press.uchicago.edu/ucp/books/book/chicago/A/bo10444942.html
UNFPA Kenya. (2016, June 27). UNFPA, Bill & Melinda Gates Foundation Committed to Boost Family Planning in Developing Countries. UNFPA Kenya. https://kenya.unfpa.org/en/news/unfpa-bill-melinda-gates-foundation-committed-boost-family-planning-developing-countries
Vere, D. (2001). Human Experiments. Christian Medical Fellowship.
Webel, M. K. (2019). The Politics of Disease Control: Sleeping Sickness in Eastern Africa, 1890–1920. Ohio University Press.
Weisz, G. (2025). The World Health Organization and the Struggle to Coordinate Global Health Research. Minerva. https://doi.org/10.1007/s11024-025-09586-y
##plugins.themes.bootstrap3.article.sidebar##
Article metrics
- Abstract Views 878
- PDF Downloads 0
- Total Engagements 878
How to Cite
How to Cite
This work is licensed under a Creative Commons Attribution 4.0 International License.