Immune organoids for Africa: a roadmap for bridging the innovation gap in infectious diseases and cancer research
Sub-Saharan Africa bears approximately 25% of the global disability-adjusted life-year (DALY) burden yet contributes fewer than 3% of global health research outputs. HIV/AIDS, tuberculosis (TB), and malaria coexist with a rising cancer burden, with attributable mortality projected to increase 75% by 2050. Fewer than 0.2% of genome-wide association study (GWAS) participants are of African ancestry, constraining precision medicine relevance. Conventional two-dimensional cultures and murine models inadequately replicate immune dynamics, tissue-level pathogenesis, and African pharmacogenomics. Immune organoids (three-dimensional microphysiological constructs) offer human-relevant platforms for mechanistic immunology, drug screening, vaccine evaluation, and precision oncology. A narrative review was conducted across PubMed, Scopus, Web of Science, and Google Scholar (January 2019–June 2025), integrating technical descriptors (lymph node-on-a-chip, patient-derived organoids, microphysiological systems) with regional keywords (sub-Saharan Africa, genomic sovereignty, STISA-2034, frugal bioengineering). Gray literature from WHO, World Bank, and Africa CDC was incorporated. Thematic synthesis identified technological advances, infrastructural barriers, regulatory gaps, and sociopolitical determinants of adoption. Lymph node-on-a-chip, tonsil-derived, and tumor–immune co-culture organoids enable high-fidelity interrogation of host–pathogen and tumor–immune interactions. Adoption is constrained by infrastructure deficits, reagent costs, energy instability, bioinformatics gaps, and nascent regulatory frameworks. Scalable solutions include a three-tier hub framework (Coordinator–Generator–Collaborator), ABCOMICS for continental genomic data governance, frugal LCD-based bioprinting, and passive microfluidic perfusion. Harmonized ethical guidelines and community-engaged consent are essential for genomic sovereignty. A phased, STISA-2034-aligned roadmap integrating frugal bioengineering, ethical governance, and targeted capacity-building can position Africa as a global leader in human-centric biomedical research, accelerating precision medicine, pandemic preparedness, and health equity.