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The Pan African Clinical Trials Registry (PACTR) is a regional register of clinical trials conducted in Africa. The registry is an African initiative serving the needs of Africans. It provides a platform where clinical trials can be registered prospectively. In addition, it also provides a searchable, electronic database of planned trials and trials currently in progress. The PACTR is unique in recognising that African trialists face additional challenges in trial registration and seeks to provide feasible ways of overcoming these. For example, a common problem for individuals living in sub-Saharan Africa is limited, unreliable and costly internet access. With this in mind, the registry provides alternative means of trial registration for registrants who do not have reliable access to the internet. Trials may be registered manually by email, postal mail or facsimile correspondence and trial registration is free.