FHI Clinical

What FHI Clinical does

FHI Clinical Inc., operating commercially as Total Trials since an April 2026 rebrand, is a privately held US-incorporated contract research organization (CRO) headquartered in Durham, North Carolina. The company delivers end-to-end clinical trial management services - protocol design, site selection, study execution, and final analysis - delivered through full-service, single-service, and Functional Service Provider (FSP) engagement models. Its core differentiation is deep specialization in resource-limited settings, anchored by long-standing infectious-disease expertise (malaria, HIV, tuberculosis, neglected tropical diseases), an oncology vertical spanning solid and hematologic malignancies, and roughly 20 additional therapeutic areas. Operations span four offices in the USA, South Africa, Kenya, and Mexico, with active trial reach across more than 70 countries in Africa, Asia, Europe, Latin America, and North America, supported by a network of 675+ (rising toward 1,000+) pre-qualified research-ready sites.

The company monetizes through professional-services contracts with pharmaceutical sponsors, biotech firms (including startups), government health agencies, regulators, academic institutions, and other CROs. No proprietary technology platform is disclosed; the company relies on partner technologies (e.g., Oracle Clinical One referenced in thought-leadership content) and standard CRO tooling. It sells exclusively through direct enterprise field sales, with no channel partners, resellers, or self-serve transactional pricing - quote-based, contractually tailored engagements are the norm. Marketing is concentrated in LinkedIn, an industry blog, conference presence, and a website-based "Instant Budget Estimate" tool used for bottom-of-funnel conversion.

The firm's growth posture is acquisition-driven: it acquired South African infectious-disease CRO Triclinium Clinical Development (TCD) in December 2021, lifting headcount to 425+, and integrated Total Diversity Clinical Trial Management in May 2026 to expand US-based patient recruitment capabilities. Recognition includes VIE Awards "Top Global CRO" finalist status for two consecutive years. The company has no disclosed funding rounds, no disclosed parent entity, no public listing, and no disclosed revenue; ownership and capitalization structure are not characterized in the source material.

Name

FHI Clinical

Legal name

FHI Clinical Inc.

Website

https://fhiclinical.com

Company type

Private

Founded year

1975

Operating status

Operating

Headcount range

251–500 employees

Short description

Total Trials (formerly FHI Clinical) is a private, US-headquartered contract research organization that runs complex clinical trials, primarily in resource-limited settings, for pharma, biotech, government, academic, and other CRO clients across more than 70 countries, with deep specialization in infectious disease and oncology.

Ownership category

akta.pro rank

Headquarters

HQ city

Durham

HQ country

United States

HQ region

North America

Offices4 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure

Revenue model

1. Contract Research Organization Services: FHI Clinical (now Total Trials) generates revenue as a full-service CRO and Functional Service Provider (FSP). Revenue is derived from service contracts with pharmaceutical sponsors, biotech companies, governments, regulatory agencies, and academic institutions for the management of clinical trials in resource-limited settings. Service models include full-service, single-service, and FSP.

Go-to-market motion1 record

Distribution channels2 records

Marketing channels4 records

Core offering

FHI Clinical (now Total Trials) is a global contract research organization that manages complex clinical research in resource-limited settings. It provides end-to-end trial management — from protocol design and site selection through study execution to final analysis — under Full-Service CRO and Functional Service Provider (FSP) engagement models for pharmaceutical sponsors, biotechs, governments, regulatory agencies, academic institutions, and other CROs.

Product overview

Total Trials (formerly FHI Clinical) operates as a mission-driven Contract Research Organization offering a unified portfolio of clinical research services. The core offering consists of Full-Service CRO and Functional Service Provider (FSP) Support models, which can be tailored to sponsor needs. These are complemented by therapeutic area specializations in Infectious Disease (malaria, HIV, neglected tropical diseases), Oncology (solid and hematologic malignancies, early phase development), and Other Therapeutic Areas (dermatology, gastroenterology, immunology, respiratory diseases). The company also offers patient recruitment services enhanced by Total Diversity Clinical Trial Management. All services are delivered globally across Africa, Asia, Europe, Latin America, and North America, with deep expertise in resource-limited settings and sub-Saharan Africa.

Differentiator

Problem solved

Functional benefit

Products and services

• Full-Service Contract Research Organization (CRO) End-to-end clinical trial management services delivered on a contract basis, covering protocol design, site assessment, trial planning, implementation, management, and final analysis, tailored to sponsor needs in resource-limited settings across 70+ countries.
• Functional Service Provider (FSP) Support Flexible, scalable functional service provider support that lets sponsors access specific CRO expertise on demand, from outbreak zones to advanced research sites, including supplemental resourcing and specialized functional outsourcing.
• Infectious Disease Research Services Specialized clinical research management services for infectious diseases including malaria, HIV, and neglected tropical diseases in resource-limited settings, with rapid outbreak response capability for global health emergencies.
• Oncology Clinical Research Services Clinical research services covering a broad spectrum of solid and hematologic malignancies, specializing in early phase development, endpoint selection, treatment response assessment and adjudication, and medical oversight of oncology trials.
• Other Therapeutic Area Clinical Research Services Clinical research services across nearly 20 therapeutic areas beyond infectious disease and oncology, including dermatology, gastroenterology, immunology, and respiratory diseases, tailored to unique study requirements.
• Patient Recruitment Services Patient recruitment services enhanced through integration of Total Diversity Clinical Trial Management, strengthening US clinical trial capabilities and patient access for sponsor studies.

Quantifiable outcome

• Supported over 500 clinical studies and 341+ trials across 70+ countries.
• +2 more outcomes

Named customers4 records

Segments4 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Partnerships

One partnership is on record.

• Total Diversity Clinical Trial ManagementcoreTechnology or Integration · 1 May 2026Total Trials integrated Total Diversity Clinical Trial Management into its global organization in May 2026, strengthening US clinical trial capabilities, patient recruitment services, and expanding the company's overall CRO service offering.

Scale indicators6 records

Recent moves7 records

Expansion highlights5 records

Broad incumbents

• Syneos Health: Syneos Health is a large, fully biopharmaceutical solutions-oriented CRO offering clinical development and commercialization services globally. Comparable to Total Trials as a broad CRO incumbent competing for outsourced trial mandates.
• Parexel International: Parexel is a large global CRO offering full-service trial management, FSP, and regulatory services across major therapeutic areas. Comparable to Total Trials as an established incumbent competing for the same pharma/biotech full-service and FSP RFPs.
• IQVIA: IQVIA is the world's largest contract research organization, offering full-service clinical trial management and FSP support across all geographies and therapeutic areas. It is comparable as the dominant global incumbent against which Total Trials competes on multi-region, especially emerging-markets, sponsors.
• Charles River Laboratories: Charles River is a major CRO offering preclinical and clinical trial services globally across multiple therapeutic areas. Comparable to Total Trials as a large, diversified CRO that competes for outsourced clinical development work.
• ICON plc: ICON is a top-three global CRO delivering full-service and FSP clinical trial management across all therapeutic areas and geographies, with strong biopharma client relationships. Comparable to Total Trials as a competing global CRO targeting pharma and biotech sponsors.

Direct peers

• Premier Research: Premier Research is a mid-size CRO specializing in complex therapeutic areas including infectious disease, oncology, and rare disease, serving biotech and specialty pharma sponsors. Comparable to Total Trials as a similarly sized CRO competing for complex-trial mandates in overlapping therapeutic areas.
• Medpace: Medpace is a mid-size full-service CRO with strong therapeutic-area expertise and a global footprint serving biopharma sponsors. Comparable to Total Trials as a similarly scaled CRO competing for the same full-service clinical trial outsourcing RFPs.
• Worldwide Clinical Trials: Worldwide Clinical Trials is a mid-size, full-service CRO specializing in complex therapeutic areas including infectious disease and oncology. Comparable to Total Trials as a similarly sized direct competitor pursuing pharmaceutical and biotech full-service and FSP engagements.

Emerging players

• Emmes: Emmes is a mid-size CRO with deep public-sector and infectious disease expertise, particularly in government and NIH-sponsored trials. Comparable to Total Trials as a peer focused on infectious disease and public-health sponsored research with similar therapeutic area overlap.

Regional players

• Novotech: Novotech is a CRO specializing in Asia-Pacific clinical trials with growing global reach and emerging-markets expertise. Comparable to Total Trials as a similarly mid-sized CRO with geography-specific specialization challenging larger global incumbents.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks5 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/Total%20Trialslinical
• Xx.com/fhiclinical

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Subsidiaries1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A1 record

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about FHI Clinical