Global cooperation in clinical research is needed to address global health issues and to provide evidence-based solutions for patients and healthcare professionals.

Multinational cooperation is essential for clinical research, as it maximises access to patients and leads to faster results. It also enables the sharing of medical and scientific expertise, tools, procedures and costs; increases the applicability of research findings; reduces duplication; and enhances methodological standards. The evidence from multinational trials can support enhanced health policy-making, health care innovation, optimal resource use, and improved patient care across borders.

Despite the advantages of multinational trials, only a very small percentage of academic trials involve more than one country; however, a significant number of industry trials are multinational, especially when they involve countries with small and medium-sized populations. 

The relative scarcity of multinational academic trials can be explained, in part, by restrictions with current cross-border funding options and lack of interoperable clinical research infrastructure. Other general barriers to multi-country collaboration include different legal, regulatory and ethical requirements; difficulties in locating investigation centres and clinical trial units (CTUs); and linguistic, insurance, contracting, and managerial and administrative issues. Due to these obstacles, investigators may forgo multinational trials in favour of trials conducted in a single centre, or in multiple centres within one country. This limits the scope of research and reduces its potential impact on the health care industry, the health economy, and society.

Governments worldwide recognise the need to develop multinational cooperation on clinical trials. To achieve this, many research institutions and organisations have come together to join the Clinical Research Initiative for Global Health (CRIGH), launched in Paris from 12 to 13 October 2016.