Tue, Dec 16, 2025 page8

• Improving nation’s clinical trials

  • By Y. Tony Yang
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  Taiwan’s clinical trials alliance is a smart move — if it treats speed as a means to earn trust, not as the mission itself. A national push to recruit personnel faster can widen access to new therapies, but only if it simultaneously makes participation safer, clearer and more worthwhile for ordinary people.

  Taiwan has launched the Taiwan Alliance of Clinical Trial Centers, bringing together 32 healthcare facilities and medical research institutes to bolster the nation’s clinical trial capacity and coordination. The public rationale is straightforward: Taiwan reportedly runs about 300 to 400 clinical trials per year, far fewer than South Korea or Australia, which are said to conduct more than 1,000 annually.

  The alliance’s practical agenda is concrete — standardizing documentation for the ethics committees that approve research involving human subjects, strengthening collaborative ethics review across hospitals, creating a trial contract template, building a database of research project managers and investigators, creating a national participant enrollment platform, training clinical trial experts, and pursuing regional and international multi-center collaboration.

  Those operational fixes matter, because global sponsors tend to choose sites that can recruit participants quickly and run trials consistently across hospitals. The alliance is explicitly designed to be a single point of contact with standardized operating procedures.

  Taiwan’s health leaders have a scientific reason to do more local trials: newer treatments are increasingly tied to molecular and genomic approaches, and responses could vary by ethnicity or region, making local evidence valuable.

  Still, the same “efficiency” logic that attracts sponsors can erode public confidence if the system starts treating people as recruitment targets rather than partners with rights — especially if ethics board coordination is perceived as reducing scrutiny, or if enrollment platforms feel like marketing funnels instead of informed consent tools.

  A more durable way to think about this alliance is to treat clinical trials like public infrastructure — closer to clean water systems than to business development. That framing changes what success means in this context: not just more trials, but fewer hidden frictions for participants (time off work, transportation, caregiving burdens), consent surprises and inconclusive outcomes where volunteers never learn what their contribution produced.

  If Taiwan becomes known not only for fast enrollment, but for being the easiest place in Asia or the Pacific to run a trial that is ethically impeccable and participant-centered, sponsors would come — and, more importantly, public willingness to participate would increase over time.

  Practical steps could include the usual standardization work the alliance already lists — plus a few trust-first upgrades that are uncommon, but feasible. Taiwan could publish a simple, nationwide “participant bill of rights” requiring every site to use plain-language consent, transparent payments, clear withdrawal pathways and post-trial access expectations.

  The enrollment platform could be built as a public interest utility with privacy by design, clear governance and auditable rules, so patients could seek opportunities without feeling trapped by any single hospital or sponsor. Return of results could become the default when scientifically valid and ethically appropriate, ensuring participation is not a one-way donation of time and data.

  And the alliance could track not only “time-to-first-patient,” but “time-to-fully-informed-consent,” protocol deviation rates and participant reported experience measures — because what gets measured becomes what gets optimized.

  The alliance’s founders and the Ministry of Health and Welfare have described the initiative as potentially benefiting the industry, patients and academic research through more efficient recruitment and greater trial activity. That triple benefit is achievable — but only if Taiwan resists the temptation to win a regional race on speed alone and instead competes on a rarer asset: credible, participant-earned legitimacy.

  If the alliance can make “ethical excellence at scale” Taiwan’s signature product — not an afterthought — then a larger trial footprint would follow naturally, and the public would have real reason to see trials not as experiments on people, but as innovation built with them.

  Y. Tony Yang is endowed professor at George Washington University and visiting professor at National Taiwan University’s College of Law.
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