CCIM

Country-Contextualised IMP Management.
A proprietary five-layer decision framework for clinical trial expansion into African corridors.

The Rêve Solutions Principle
Africa is not an execution problem waiting to be solved. It is a decision problem waiting to be structured. Sponsors who approach Africa through a rigorous Go/No-Go decision framework — rather than defaulting to operational assumptions — achieve faster entry, lower rework costs, and significantly stronger governance outcomes.
— Foundational Principle of the CCIM™ Framework

Five decision layers.
One defensible outcome.

CCIM™ evaluates expansion readiness across five sequential decision layers. Each layer must be fully assessed before a responsible Go/No-Go decision can be made.

The framework sits above CRO execution and logistics vendors — it focuses on decision readiness, risk clarity, and economic rationale. Only when all five layers are understood can sponsors make a responsible expansion decision.

From foundation to strategic ROI.

Layer 05
Strategic ROI
Layer 04
Residual Risk Transparency
Layer 03
Governance & Escalation
Layer 02
Corridor Feasibility
Layer 01 · Foundation
Program Sensitivity Assessment
CCIM™ Decision Framework · Read bottom to top
01
Foundation

Program Sensitivity Assessment

Not every program is suitable for Africa expansion — understand yours first.

The first step is to evaluate whether the program's characteristics can tolerate the operational variability inherent in emerging-market corridors. This is not a judgment on Africa — it is a scientific and operational fitness assessment that must be conducted for any complex trial geography.

A
IMP characteristics. Temperature profile (2–8°C, frozen, ambient), stability and shelf life, manufacturing batch flexibility, and replacement batch lead times — each shapes corridor selection and shipment frequency.
B
Patient sensitivity. Disease severity, treatment criticality, ability to delay dosing, and impact of supply interruption on patient safety and data integrity.
C
Trial design parameters. Recruitment targets, adaptive design sensitivity, and protocol flexibility — quantified against Africa's recruitment advantage.
Programs with highly sensitive biologics, short shelf lives, and strict dosing schedules require stronger CTS infrastructure before expansion can be considered. Programs with robust IMP characteristics are strong candidates for African entry.
02
Corridor Design

Corridor Feasibility & Supply Chain Design

The question is not whether Africa works — but whether your corridor works.

Each corridor must be analysed end-to-end: origin manufacturing → export airport → international transport → import customs → regional depot → clinical site. The viability of a specific corridor determines the operational foundation of the entire trial.

A
Customs & import predictability. Clearance timelines, documentation complexity, cold-chain handling during holds, import permit lead times (typically 4–16 weeks by market).
B
Airport & transit infrastructure. Pharmaceutical handling certification at origin and destination, cold-chain capacity, transit hub reliability, direct vs. connecting routing.
C
Depot & storage capabilities. Validated storage conditions, backup power, deviation protocols, qualified person availability, GMP compliance status.
D
Site-level handling. Pharmacy infrastructure, trained personnel, temperature monitoring, IP accountability, sponsor-aligned destruction protocols.
E
Last-mile logistics. Local partners with regulatory expertise and established cold-chain networks — not global 3PLs with African subsidiaries.

Corridor Classification

Green
Operationally viable with standard risk management
Amber
Viable with specific mitigation and enhanced monitoring
Red
Operational risk exceeds threshold — not recommended
03
Governance

Governance & Escalation Structure

Disruptions will occur — the question is how fast and clearly decisions get made.

Clinical Trial Supply disruptions are inevitable in any emerging-market corridor. Operational success depends not on preventing all deviations, but on having a governance structure that enables fast, clear, documented decisions when they occur. CCIM™ defines CTS as a Critical-to-Quality (CtQ) system, aligned with ICH E6(R3) expectations for sponsor oversight.

A
Authority matrix. Pre-defined roles for IMP release after temperature excursion — with escalation paths and time-to-disposition targets agreed before site activation.
B
MTTD targets. Mean Time to Disposition benchmarks set before the trial begins — not during a live deviation.
C
Escalation pathways. Documented protocols connecting site, depot, logistics provider, sponsor QA, and medical monitor.
D
Personnel qualification. Verified training standards for site pharmacists, depot staff, and logistics coordinators — not assumed.
Under ICH E6(R3), sponsors bear explicit accountability for the quality of CTS systems — including those operated by CROs and third-party logistics providers. A governance framework defined before execution begins is not optional. It is a regulatory expectation.
04
Risk Transparency

Residual Risk Transparency

Acknowledge what cannot be eliminated — before it becomes a crisis.

Even the best-designed supply chains cannot eliminate all risks. Responsible expansion requires that residual risks be formally acknowledged, documented, and accepted at the appropriate leadership level — before operational commitments are made.

01
Customs delays. Variable clearance timelines, potential cold-chain exposure during holds. Mitigation: pre-approved import permits, bonded warehouse bridging stock.
02
Power instability. Backup power failures at depots or clinical sites. Mitigation: validated generator backup, continuous monitoring with automated alerts.
03
Logistics disruptions. Transport failures during regional crises, weather events, or infrastructure issues. Mitigation: multi-carrier contingency routing, regional buffer stock.
04
Replacement batch lead times. Limited availability under tight manufacturing schedules. Mitigation: pre-negotiated emergency batch protocols.
05
Political & infrastructure risk. Country-specific instability affecting site access or import clearance. Mitigation: country risk scoring, multi-country diversification.
Transparency ensures that operational teams are not forced to absorb risks that were never acknowledged at leadership level — a pattern that drives both governance failures and team burnout.
05
Strategic ROI

Strategic & Financial Return on Investment

Africa expansion must demonstrate tangible value — not just diversity optics.

Beyond operational feasibility, sponsors must understand the strategic and economic rationale for expansion. Three major economic drivers support a Go decision:

5.1
Faster patient recruitment. Lower competition between trials, treatment-naive populations, and high prevalence of indication-specific diseases. Even a 10–15% improvement in recruitment speed can represent tens of millions in value for high-priority programs.
5.2
Regulatory strategy & approval confidence. Global regulators increasingly emphasise representative clinical populations. Diverse African inclusion may strengthen submissions, reduce post-marketing commitments, and support parallel approval strategies as the African Medicines Agency operationalises.
5.3
Long-term market development. Africa's 1.4 billion population represents one of the fastest-growing pharmaceutical markets. National insurance expansion, global health funding (Global Fund, GAVI, WHO), and tiered pricing models create substantial long-term commercial opportunity.

The CCIM™ Decision Pack.

CCIM™ produces a structured Decision Pack for sponsor leadership — the evidence base for a defensible Go/No-Go decision that aligns clinical operations, supply chain, regulatory affairs, and executive leadership before any operational commitment is made.

01
Program Sensitivity AssessmentIMP and protocol fitness scoring with explicit suitability rationale.
02
Corridor Feasibility ClassificationGreen / Amber / Red rating by country and route, with end-to-end gap analysis.
03
Governance StructureMTTD targets, escalation authority matrix, and ICH E6(R3)-aligned oversight design.
04
Residual Risk RegisterDocumented residual risks with formal sponsor acceptance documentation.
05
Strategic ROI AssessmentQuantified recruitment, regulatory, and market-development value.
06
Final RecommendationGo / Conditional Go / No-Go — with the evidence chain to defend it.
● Outcome A
Go
Expansion recommended with defined operational corridors and acceptable residual risk.
● Outcome B
Conditional Go
Expansion possible with specific risk mitigation measures and governance enhancements.
● Outcome C
No-Go
Operational or strategic risks exceed acceptable thresholds. Revisit in 6–12 months.

Ready to change your vision angle on Africa expansion?

Rêve Solutions partners with sponsors at the decision layer — providing the regulatory intelligence, corridor expertise, governance design, and strategic ROI analysis that turns Africa from a question mark into a confident strategic commitment.

Request a CCIM™ briefing Back to home