Report summary

Clinical trials are a core component of advancing medical progress in a safe and ethical manner. As they involve complex manufacturing, a globalised supply chain and in-person monitoring, they generate a substantial quantity of emissions, calculated at 2.0mn tCO₂e in 2023.

Despite a growing awareness of sustainability across major healthcare systems, heightened by WHO initiatives, inconsistent data and a lack of relevant tools to drive insight hinder targeted action. Enhancing existing state-of-the-art frameworks, such as Risk-Based Monitoring, which is designed to optimise for efficiency, is a good anchor from which to add on sustainability considerations.

Areas of investigation include gaining a deeper understanding of the sources of trial emissions, exploring the pattern of remote monitoring visits over time, examining the supply chain and investigating the regulatory environment that facilitates decentralised clinical trials.

By rethinking existing processes, immediate success can be had that aligns clinical research with climate goals while maintaining scientific, regulatory and commercial integrity.

Key findings

• Digitise to enable centralised monitoring. Reducing the need for in-person visits.
• Minimise unnecessary travel of Staff, Patients, and Goods. Decentralised Clinical Trials offer a promising avenue for reducing unnecessary patient travel.
• Procure Sustainable Trials. Sponsors must commission sustainable trials and collaborate with partners to implement KPIs and effective solutions.
• Engage regulators to advocate for remote operations. Adapt regulations to enable DCTs and perform a larger proportion of visits remotely.
• Reduce energy expenditure and waste from Labs.