Energy powers every aspect of our lives—from how we commute to the way we heat our homes. However, when it comes to sustainability and energy transition, we often overlook areas that seem far removed from the conversation, such as clinical research. Yet, energy usage and sustainability are deeply intertwined with medical research, from the laboratories where samples are processed to the logistics of transporting equipment and trial participants. At the 7th International Clinical Trials Methodology Conference 2024, it was refreshing to see how sustainability is increasingly integrated into clinical trial design and operation.

One of the most striking takeaways from the conference was the emphasis on rethinking the carbon footprint of clinical trials. It was encouraging to see the next generation of researchers and trialists considering environmental sustainability as a core element in their methodologies. This shift represents a broader understanding that the energy transition is not separate from the field of medical research but rather a critical aspect of it.

The biggest carbon culprits in clinical research

The primary sources of emissions in clinical trials stem from several areas. Transport is a major contributor, whether it’s moving medical equipment, transporting biological samples under controlled conditions, or the travel of doctors, researchers, and patients to and from research sites. Additionally, energy-intensive processes, such as freezing and storing samples in temperature-controlled environments, are significant factors in the carbon footprint of research facilities.

A discussion led by prominent pharmaceutical companies like AstraZeneca and Johnson & Johnson at the conference demonstrated that these issues are being taken seriously. These companies are exploring ways to mitigate their environmental impact and support the energy transition within their research operations.

Bringing sustainability to the forefront of clinical trials

Incorporating sustainability into clinical trials cannot be an afterthought; it must be embedded in the planning and design stages. Managing the carbon footprint of trials starts at the research facilities themselves, where trial units can implement more efficient energy use and resource management strategies. The network of trialists at the conference highlighted the importance of co-designing solutions with communities and stakeholders affected by these changes. This approach ensures that sustainability measures are practical, inclusive, and supported by the people who will implement and be impacted by them.

Collaboration is key. Corporate partners, governments, and communities must come together to drive innovation. While pharmaceutical companies and governments can provide the resources and frameworks needed for greener clinical trials, communities and patient groups bring valuable insights and experiences that can shape practical and inclusive solutions.

Innovative pathways for sustainability in trials

A critical aspect of making clinical trials more sustainable is rethinking the processes themselves. For example, decentralized trials, which reduce the need for participants and researchers to travel extensively, can significantly decrease the carbon footprint of research. Innovations in artificial intelligence (AI) and logistics could optimize sample transportation and storage, making the entire process more energy-efficient.

It is also important to consider the diversity of approaches required. Different regions, demographic groups, and communities may require tailored solutions based on their specific circumstances. This complexity underscores the need for a multidisciplinary approach that includes the perspectives of all stakeholders involved, from pharmaceutical companies to underrepresented communities.

Embedding sustainability systemically

One crucial point that emerged from the conference is that there is no one-size-fits-all solution for integrating sustainability into clinical research. The energy transition will look different across the various actors involved, including pharmaceutical companies, researchers, clinicians, and academic institutions. While systemic change is needed, it must be approached with flexibility, recognizing the unique challenges and opportunities each sector faces.

The changes that last and create real impact are those co-created with the community, where the voices of the affected individuals shape the solutions. As clinical trials increasingly take a patient-centric approach, the opportunity to involve patients in sustainability efforts grows. Citizen science initiatives and engaging underrepresented groups can lead to more inclusive, effective research that not only addresses scientific objectives but also considers the environmental impact and the well-being of all involved.

Moving forward with a multidisciplinary approach

The path ahead requires more support for research into the environmental effects of clinical practices and the health implications of climate change itself. Collaboration with funding bodies and grant schemes is essential to ensure that sustainability remains a priority. These funding structures need to adapt, encouraging innovations that reduce the carbon footprint of clinical research while enhancing the inclusivity and reach of trials.

Ultimately, the energy transition in clinical research must go beyond addressing individual carbon footprints. It must be systemic and inclusive, integrating the human aspect and ensuring that underrepresented communities are not sidelined. While we may not yet have a clear roadmap, the conversations and innovations happening today are crucial first steps.

In the end, there may not be one "right" answer that applies everywhere, but the willingness to think critically, innovate, and engage diverse perspectives shows promise. Sustainability in clinical research is about reimagining how we conduct trials, balancing the needs of people and the planet, and ensuring that the energy transition benefits everyone involved.