Recruiting more minority physicians into clinical research should be the first step in addressing the continuing under-representation of African Americans in the field, argues an opinion piece in The Washington Post.

Government agencies and research companies “must proactively reach out to physicians practising in minority communities and reduce the barriers of time, money and training that make it difficult to incorporate clinical research into the general practice of medicine”, write Ken Getz, chairman of the Center for Information and Study on Clinical Research Participation, and Doug Peddicord, executive director of the Association of Clinical Research Organizations.

While the African American, Latino and Asian populations account for around one third of all Americans, they make up less than one tenth of clinical trial participants in the US, Getz and Peddicord point out.

Much of the blame, they say, is down to too few minority physicians taking part in clinical research. “Black and Latino physicians are more likely to treat patients of similar race and ethnicity, and there is considerable evidence that a physician’s race is an important factor in influencing patient participation in a clinical trial.”

For African Americans, there is also the long shadow cast by the notorious Tuskegee experiment, in which poor and uneducated black men with syphilis were left untreated from the 1930s to the 1970s in a trial run by the US Public Health Service.

“Acknowledging the fact that Tuskegee remains a touchstone of African American mistrust of the medical system is essential,” Getz and Peddicord comment. However, they also suggest it is time for the clinical research community and the public to put “the inexcusable history of Tuskegee” behind it.

This may already be happening. A review of recent clinical studies showed that younger African Americans were as willing to take part in clinical research as non-African-Americans, while the legacy of Tuskegee “was not cited as a major deterrent to enrolling in a study”, the authors point out.

Without the participation in clinical research of all races and ethnicities, promising new drugs cannot be fully evaluated for safety and effectiveness, Getz and Peddicord stress. There is a growing body of evidence that minority and ethnic populations respond differently to some drugs.

There is also a “desperate need” for new therapies addressing diseases that disproportionately affect African Americans. For example, they have “one of the highest rates of blood pressure in the world”, are twice as likely to have diabetes than whites and are the population most likely to develop sickle-cell anaemia. African Americans also have the highest asthma rate of any racial or ethnic group in the US and the highest mortality rate for all cancers combined, Getz and Peddicord note.