Clinical trials in Jamaica: no law, and few Black patients in GLP-1 data

Semaglutide and tirzepatide reach Jamaican clinics with evidence built almost entirely abroad, and the same is true of newer drugs such as retatrutide still in trials. Very little of it was generated on the island or in populations like Jamaica's. Part of the reason is structural: Jamaica oversees research on people through research ethics committees rather than through a clinical trials statute. This article looks at both gaps, the legal one and the evidence one, and why they matter to Jamaican physicians.

How human research is overseen in Jamaica

The clearest published picture comes from a study by D. Aarons, published in Developing World Bioethics, which interviewed Ministry of Health officials, public health practitioners and research ethics committee members in Jamaica and Saint Lucia¹. The findings for Jamaica were blunt: "Jamaica has four (4) functioning research ethics committees", and "Currently there is no interaction between the various research ethics committees in Jamaica"¹. Respondents described "significant delays in assessing protocols" and said some applicants "actually begin their research before approval is given"¹. One recommendation stood out: "In the medium to long term, Jamaica needs legislation for research with human participants"¹.

The concern is not new. In a 2007 West Indian Medical Journal editorial, Dr A M Mullings of UWI noted that a worldwide review had identified the Caribbean as one of the areas "with only a few published guidelines" and urged the region to "develop and implement local standards for compliance"². A 2022 Pan American Health Organization assessment of 22 Latin American and Caribbean countries found that most had adopted legal instruments for research with human participants and national bodies to oversee ethics committees, but that ethics training and clinical trial registration lagged³.

A regional comparison: Saint Lucia's Clinical Trials Act

Jamaica's neighbours have moved. Saint Lucia's Revised Laws (2023) contain a Clinical Trials Act⁴. Section 35 lets the Minister make regulations on technical progress in clinical trials, international regulatory developments, safety information on medicinal products and the procedure of the Ethics Committee, and says breaches may carry a fine of up to $10,000 "or to a term of imprisonment not exceeding 2 years or to both"⁴. Jamaica has no equivalent Act.

Jamaica does take part in trials

The lack of a statute has not stopped research. In 2016 Health Minister Dr Christopher Tufton announced that Jamaica would take part in clinical trials in an international, WHO-supported effort toward a Zika vaccine⁵. In April 2026 the Jamaica Information Service reported that UWI's Dr Simone Badal planned to resubmit one cancer trial for a Wellcome grant of "just under £5 million", and that early findings point to "differences in how patients of African descent respond to certain anti-cancer drugs"⁶. And in 2024 a report on a UWI Mona graduate whose glutathione and S-nitrosoglutathione combination improved blood sugar in diabetic rats noted that human trials of the combination had begun in other countries, but "Jamaica currently has no such programme"; he proposed engaging the Faculty of Medical Sciences' clinical research unit as a next step⁷.

The evidence gap in GLP-1 trials

The second gap is in the data physicians use. A 2024 systematic review in BMJ Global Health identified 27 randomised trials of GLP-1 medicines for obesity with 21,547 participants⁸. White participants made up 79%, Black participants 9%, Asian 13% and Indigenous 2%, and the 1,859 trial sites were predominantly in high-income countries⁸. Compared with the general population, non-white people were under-represented by 23% against the United States and by 68% against South Africa⁸.

That matters for outcomes. A 2026 meta-analysis of nine randomised trials with 81,266 patients found that GLP-1 receptor agonists reduced major adverse cardiovascular events in Caucasian patients (RR 0.87) but showed no significant difference in Black patients (RR 1.05; 95% CI 0.72-1.53)⁹. The authors said this "suggests potential racial disparities in the enrollment and efficacy"⁹. A wide confidence interval from small numbers is not proof that the drugs work less well; it is proof that the trials did not enrol enough Black patients to know.

Jamaica has a large stake in that answer. In a 2026 analysis of the Jamaica Health and Lifestyle Survey III, rural Jamaican adults had obesity prevalence of 28.9%, diabetes 12.8% and hypertension 34.5%¹². Wider in Latin America and the Caribbean, a scoping review found few trials that included ethnic minorities, and only 15 of 24 reported approval by a research ethics committee¹⁰.

What would change it

• A legal basis for trials and ethics review, as the Aarons respondents recommended, with coordination between Jamaica's committees¹.
• Trial registration and ethics training, the two indicators where PAHO found the region furthest behind³.
• Capacity for efficient trials. WHO's 2024 Guidance for best practices for clinical trials, issued at the request of the World Health Assembly, is meant to make clinical research more efficient and reduce waste¹¹.
• Post-approval monitoring at home. Until local trials exist, Jamaican data on GLP-1 safety will come mainly from reports to the Ministry's PharmWatch scheme¹³; see our article on reporting GLP-1 side effects in Jamaica.