Difficulty writing proposals and gaining funding

Little local funding, competitive international funding

Technical ability and confidence lacking

Unsure of funding process; investigators do not complete application

Lack of training

Slow regulatory and ethical approvals

Complex and unclear guidelines

Limited ethical review capacity

Poor-quality submissions

Problems with trial management

Lack of experience and poor planning

Burdensome administration and difficulty purchasing supplies

Complex and slow systems

No administrative support

Problems with setting up and running laboratory tests

Limited funds and facilities

Difficulty purchasing supplies

Lack knowledge in technologically advanced procedures