The progress on cancer diagnosis and treatment has attained, in the last decade, enormous achievements by any estimate. Immunotherapy, new generations of targeted therapies, Chimeric antigen T-cells, cancer vaccines and the fascinating breakthroughs in translational research and cancer biology have changed the direction of cancer care. However, the fact that all patients worldwide cannot have access to these advances is dramatic. Alongside this, taking part in clinical research is one way to improve and invest in cancer care. Patients from African—and most low-resources countries—are rarely offered the chance of being included in clinical trials.

This well-known fact paints a disheartening picture of what having cancer is like in the poorest settings. This situation will further decline with population aging, major changes in risk profile imported from developed countries and life expectancy increasing in most African countries. If no radical changes are made, this North–South contrast will become more critical and continue to grow. Yet, there is room for hope because only when we acknowledge the problem can we begin to address it. We need a better understanding of the reasons behind this gap and to advocate for more representation from African patients in clinical trials, with respect to the socio-economic, epidemiological and unique demands of each country across the continent.