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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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A narrative review was conducted across PubMed, Scopus, Web of Science, and Google Scholar (January 2019\u2013June 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>Lymph node-on-a-chip, tonsil-derived, and tumor\u2013immune co-culture organoids enable high-fidelity interrogation of host\u2013pathogen and tumor\u2013immune 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\u2013Generator\u2013Collaborator), 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s43046-026-00385-4","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T07:16:21Z","timestamp":1784099781000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Immune organoids for Africa: a roadmap for bridging the innovation gap in infectious diseases and cancer research"],"prefix":"10.1186","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2970-0692","authenticated-orcid":false,"given":"Ahmad Onikoko","family":"Abdulgafar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adeyemi Sallam","family":"Febilola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Rono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chinemerem Henry","family":"Ugo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saerimam Nzunde","family":"Markus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariam Iyabo","family":"Adeoba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dagunduro Emmanuel","family":"Tolu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"385_CR1","doi-asserted-by":"publisher","first-page":"2133","DOI":"10.1016\/S0140-6736(24)00757-8","volume":"403","author":"GBD 2021 Diseases and Injuries Collaborators","year":"2024","unstructured":"GBD 2021 Diseases and Injuries Collaborators. 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