Collaborative clinical trials on infectious disease among the G20 nations using scientometric analysis

Increased international travel and trade, changes in lifestyle, microbial resistance, and climate change, which allow endemics to proliferate, all contribute to the accelerated spread of infectious diseases (IDs). It is crucial to collaborate through shared knowledge and skills to combat these risks. Prioritizing clinical trials in infectious disease (CTI) in a cooperative and multipronged manner is essential to the successful elimination of threats. Building a strong research and innovation ecosystem is one of the important agendas of the G20 presidency in responding to these global crises (e.g., Ebola and Zika). India gears up for its 2023 G20 presidency, as the global economy teeters on the brink of recession as it recovers from the grip of COVID-19. At this juncture, it is beneficial to obtain a macroscopic overview of the state of collaboration between G20 nations in CTI research.

Studies published by G20-affiliated authors between 2010 and 2022 were retrieved from PubMed and the Web of Science using relevant search strategies. After data cleaning using a thesaurus file, duplicates were eliminated and the collectively represented European Union (EU) member states were categorized as "EU" except France, Germany, and Italy, as they are individually represented in G20. The final dataset, consisting of metadata of articles extracted from the Web of Science, was used for bibliometric analysis using VOSviewer. Coauthorship and co-occurrence analysis were performed as components of the bibliometric analysis.

A total of 3,636 articles were included. Between 2013 and 2014, publications with international collaborations increased by 5.8%. The USA contributed the most publications among G20 nations (28.2%), followed by the UK (10.3%) and Germany (6.2%). India ranked 13th, accounting for 2.4% of all publications. Frequently occurring keywords included HIV/AIDS, COVID-19, hepatitis, and influenza. From 2010 to 2022, India collaborated with G20 nations on over 203 clinical trials, collaborating most closely with the USA, followed by the UK and Australia.

Most collaborative clinical trials among G20 countries involve the USA, the UK, and Germany, likely reflecting higher research funding capacity and advantages such as English proficiency in industrialized nations. Rethinking and incentivizing funding policies in health research could improve participation and output across countries. The prominence of viral infections—HIV/AIDS, COVID-19, and hepatitis—among frequent keywords indicates strong international collaboration focus in these areas, with a sharp increase in COVID-19-related research during the pandemic. Sustained political will is needed to maintain cooperation and collaboration, particularly to address the resurgence of diseases driven by COVID-19-related disruptions. Although strategies exist to encourage LMICs to reach their publication potential, progress is lagging relative to the need to prevent and control high-burden infections. The study offers policymakers and stakeholders a macro perspective on collaborative clinical trials to guide future research addressing infectious disease threats, and underscores the need for global leadership through cooperative entities like the G20.

This study provides a macro-level overview of collaborative clinical trials in infectious diseases among G20 nations, highlighting the dominant roles of the USA, the UK, and Germany, and the concentration of collaborations around viral infections such as HIV/AIDS, COVID-19, and hepatitis. It underscores the need to rethink and incentivize funding policies to broaden participation, particularly for LMICs. Future research should examine facilitators and impediments to collaboration, supported by strong global leadership through cooperative entities such as the G20.