Bridging the Gap Between Clinical Trials and Access: Launching the Yale Medicines Access Network (YMAN)
Across the globe, patients in low- and middle-income countries (LMICs) are increasingly participating in clinical trials that support regulatory approvals of novel medicines. Yet too often, once those medicines are approved—particularly by the U.S. Food and Drug Administration (FDA)—they remain unavailable in the very countries where they were tested.
This disconnect between research participation and post-trial access is not new, but it is increasingly urgent. Recent analyses have shown that novel oncology drugs are frequently tested across a wide range of countries, yet are rarely submitted and approved for marketing in many LMICs that hosted those trials.
To address this gap, Bioethics International (BEI), in collaboration with Yale, is proud to support the launch of the Yale Medicines Access Network (YMAN)—a new, action-oriented partnership designed to improve local access to novel medicines in LMICs.
A Network Built for Action
YMAN brings together health ministers, heads of oncology centers, regulatory experts, and clinical trial investigators from across Africa and beyond. Initial country engagement focuses on Nigeria, Uganda, Rwanda, Kenya, Ethiopia, Tunisia, and Zambia—regions where clinical research activity is growing, but access challenges remain significant.
Funded by the Yale in the World Fund in 2025, YMAN builds on years of prior research and collaboration between BEI and global partners. This includes foundational work published in JAMA Network Open (2021) and JAMA Internal Medicine (2026), as well as insights from Bioethics International’s annual roundtables and partnerships with industry and global health organizations hosted since October of 2009.
From Evidence to Implementation
YMAN is grounded in rigorous research. A mixed-methods study—supported by an unrestricted grant—combined a systematic literature review with in-depth interviews of health ministers, oncology leaders, and trial investigators across multiple LMICs. This work identified key facilitators of access to novel oncology drugs, helping to shape a practical, evidence-based framework for action.
But YMAN is not just about generating evidence—it is about applying it.
The network’s first priority is to improve physical access to novel oncology drugs in countries where they were tested. This is initially defined as ensuring that these medicines are submitted for regulatory approval and made available for marketing in those countries.
Centering Local Leadership
A core principle of YMAN is partnership with local stakeholders. Network members include leaders from cancer institutes, hospitals, regulatory bodies, and global health organizations who are directly engaged in addressing access challenges on the ground.
By centering local expertise and priorities, YMAN aims to ensure that solutions are not only ethically grounded, but also practical, scalable, and responsive to real-world health system needs.
Measuring What Matters
YMAN is designed with accountability in mind. The initiative includes clearly defined, measurable goals:
- Publishing research findings on barriers and facilitators to access
- Demonstrating measurable improvements in access to novel medicines, tracked through tools like the Good Pharma Scorecard
- Convening global and regional stakeholders through in-person meetings in 2026, including in Nairobi and New York
Progress will be evaluated through ongoing research updates and benchmarking efforts, ensuring that the initiative remains data-driven and impact-focused.
A Call to Collaborate
Ensuring equitable access to medicines is a shared responsibility—across industry, regulators, researchers, and health systems. YMAN represents a new model for collaboration: one that moves beyond identifying problems to implementing solutions.
As the network launches its first series of convenings in 2026, we invite partners across sectors to engage with this work—whether through research, policy, or practice- because participation in clinical trials should not be a one-way exchange.