SIGNIFICANCE: The 2022 Decadal Plan for Science, Technology and Innovation intends to shape innovation activities and their contribution to development out to 2031, serving as government master plan and pivoting the National System of Innovation to mitigate the socio-economic, health and environmental challenges of times that are volatile, uncertain, complex and ambiguous. But in trying to be all things to all people, the Decadal Plan avoids prioritisation, reading more as a Vision Statement than an Implementation Plan.

Multinational pharmaceutical companies ('pharmas') import and produce pharmaceuticals and also conduct clinical trials which are an important aspect of research and development (R&D). This may raise the question: Is South Africa a guinea pig for the pharmas? The Department of Trade and Industry National Industrial Policy Framework¹ designates chemicals, plastic fabrication and pharmaceuticals as a key value chain. So a second question could be: Can South Africa be a manufacturer for the pharmas, or can it leverage strengths in medical research and the conducting of clinical trials so as to develop a discovery-led industry? This paper analyses and quantifies the state of the clinical trials industry in South Africa, and concludes that: (i) a sizeable clinical trials industry exists, and that these trials are predominantly phase 3 and global in scope; (ii) South Africa is not a specific or unique guinea pig - a range of conditions is studied as part of global trials; and (iii) while South Africa has excellent prospects for increased clinical trials activity, R&D investment is too low to make it a major pharmaceutical contender.

Internationalization of trade has extended to services and intangibles such as research and experimental development (R&D). The emergence of knowledge economies with porous borders raises questions concerning the preparedness of countries to manage their systems of innovation in response to these changes. This article draws on the recently completed 2004/5 R&D survey, and other local and international data sources to consider the extent to which South African R&D is positioned to respond to the challenge of the internationalization of R&D. This entails looking at the behaviour of the main role players in the system of innovation, the extent to which they are open to local and global interactions, competitive advantage, and the implications for policy. The evidence suggests that, from an R&D perspective, the emerging South African knowledge economy is still more 'closed' than 'open'. Actions that may contribute to attracting international R&D investment and collaboration include development of skilled people and the further enhancement of direct and indirect R&D incentives.