Conducting clinical trials only in India’s large cities is unlikely to sample the country’s ethnicity sufficiently well

Around the world, there have been calls to include parti­cipants of diverse ethnicities in every clinical trial. In India, some years ago, a Parliamentary Committee was informed that trials are run in cosmopolitan cities of the country, and that this ensured suitable ethnic representation. The Indian Council of Medical Research, New Delhi, has defined six zones of the country from where sampling needs to be done to ensure good ethnic coverage. We found that no city has adequate representation from all the zones. However, possibly, a suitable sampling strategy in some cities could replace running trials from a few zones