In a world that seems at times more divided than ever, where tolerance, understanding, and acceptance can feel like virtues long since abandoned in pursuit of self interest in commercial and political spheres, healthcare can often be an outlier for demonstrating the best of humanity, a compassion for the person behind the patient. The Hippocratic oath, medicine’s foundational tenet, should however be entrenched in all of healthcare’s constituent parts. Primum non nocere means not simply doing what’s best for the patient at the point of care, but should also uphold the values of inclusivity, equitability, and accessibility. By not including significant swathes of the human population in research, we are in fact doing untold harm to those we are excluding.

Research in medicine has to be representative, longstanding inequalities perpetuated by years of neglect, discrimination, and inertia has created an elite, myopically driven system and one that has simply failed to grasp what diversity at its core means and how it can contribute to medicine. None more so than when we look to the African continent—often seen as the cradle of all human populations, and home to substantial genetic diversity. Despite its foundational role in human evolution, the African genome is still largely underrepresented in genetic studies today. This paucity limits our knowledge of human evolution and clearly hinders the development of valuable data sets that can translate to tailoring precision therapeutics to patients of African ancestry.

There is, however, a vanguard of scientists around the globe challenging the status quo—creating more inclusive research programs, mitigating the disparities that prevent access to healthcare, and engendering trust amongst underrepresented communities in order to boost diverse clinical trial participation. This is a moral challenge and one that centers around protecting often the most vulnerable in society; we need to do more to actively engage with communities that have been left behind, this is about justice, fairness, and beneficence. We are all accountable in making sure we create a more equitable biomedical landscape—the Belmont Report was written in 1978, and after nearly 50 years, its aforementioned founding principles relating to the ethical conduct of research involving humans holds true today. Perhaps there should be a clarion call to rethink a revised framework, future proofed for a new era in biomedical research that reflects not only the needs of communities today, but also the ongoing evolution of research practices to come.