Increased domestic investment in health research and development across Africa could generate $668 billion in returns for the continent’s economies over 20 years, a new report found.

The goal could be achieved if African governments meet the African Union’s call to invest 1% of their GDPs in health — which would amount to about $28 billion — said the Africa Centres for Disease Control and Prevention and Team Europe, which together issued the research.

Africa carries 25% of the global disease burden — a measure of the total impact of illness on people worldwide. Yet only 1.1% of clinical trials globally are carried out on the continent. The result is that the diseases most prevalent in Africa are not prioritized; meanwhile, African nations rely heavily on imported medicines, and health workers often relocate overseas. However, a new head-of-state-led initiative aimed at giving African governments more control over their health systems — dubbed the Accra Reset — was announced last year.