Cardiovascular diseases are the leading cause of death globally and in every region the burden is increasing as populations’ age. Despite the rapid growth of cardiovascular disease across Africa and Asia, these populations are under-represented in clinical research and under-served by existing therapies. There is a pattern of historical under-representation in these populations that needs addressing. As clinical research data improves our understanding of disease progression and treatment effects, and are incorporated in algorithmic risk models, clinical decision-making will improve rapidly, but only for patients represented in research. Geography and ethnicity are both important variables in existing risk models, but there is insufficient data gathered in the Middle East, Africa and Asia to build robust models for application in these populations. There is a clinical and societal imperative to conduct thrombosis research in populations under-represented in existing research and under-served by existing interventions, to inform health policy and priorities, and improve patient outcomes. CYTE is in the uncommon position of having already established a clinical research infrastructure within the Middle East, Africa and Asia, including 863 sites in 24 countries and counting. As we continue to expand across these regions, we are committed to generating new evidence and insights about how best to improve patient outcomes in these populations and effectively utilise their constrained healthcare resources.