Examining Sustainability in Clinical Research

Posted in Process Improvement

A New AQC Innovation Initiative

For more than a decade, the Avoca Quality Consortium (AQC) has emphasized the importance of driving change in the clinical trial execution process. This is predicated on our belief that organizations, working together, could realize change more effectively than organizations working in silos. Now we have the unique opportunity to augment our innovation initiatives to increase sustainability in clinical trials.

The healthcare sector is responsible for 5.2%[1] of greenhouse gas (GHG) emissions, which is approximately 2.7 billion metric tons of CO2. This is more than double that of global aviation (2.5%)[2] and equivalent to the emissions of 720 coal-fired power plants.[3] Moreover, in clinical trials, we contribute up to 100 million tons of CO2 to that total, or about 27 coal-fired power plants which equals 19.5 million US homes’ electricity usage for one year. The World Health Organization (WHO) has noted that to effectively protect the health of populations, health systems have the double responsibility of building climate-related health resilience and reducing their own carbon footprint.[4] As scientists, we must seek solutions to this crisis. We must prioritize the search for opportunities that lead to a healthier, cleaner, and safer environment rather than continuing current “business as usual” practices.

Clinical trialists have a unique opportunity to lead medical innovation while also acting as environmental stewards. In this series of blogs focused on sustainability in clinical trials, we hope to provide a landscape for tactical and specific actions you can take in your role in clinical trials. Health systems consist of organizations whose primary intent is to promote, restore, or maintain health.[5] Whether you are a CRC, CRA, or CEO, and whether you work in a small CRO or a large Pharma company, you can contribute to increasing sustainability in clinical research to protect the health of current and future generations.

Some AQC members’ solutions include:

  • The PPD clinical research business of Thermo Fisher Scientific, is composting leftover food at a Phase I clinic that enrolls over 2,000 patients and screens 8,000 annually and its Phase II-IV clinic uses Uber Green (hybrids and EV) wherever available for patient transportation.
  • Bayer has been donating surplus lab kits from clinical trials in the US to Kits4Life since 2020, thereby diverting unused kits from landfill and repurposing them for humanitarian aid and to educational institutions. Expanding its work with Kits4Life outside of the US is ongoing.
  • Novartis has smartly consolidated medication shipments to clinical sites, reaching a reduction of almost 50% or –42,000 shipments in 2022. Additionally, they have introduced reusable shipper boxes across almost all cool-chain clinical site shipments and have put policies in place to avoid the medication frontloading of clinical sites prior recruitment once feasible.

Consider this an opportunity for you to find out what actions your company is taking related to sustainability as well as specifically thinking about how you and your team can contribute to running clinical trials with a reduced environmental impact.

AQC members can view a recording of the sustainability initiative kickoff meeting in the Knowledge Center.

We look forward to you joining us as we continue the conversation into 2024.

Learn more about becoming a member of the AQC to get involved!
Contact Us


Jürgen Wieland

Development Environmental Sustainability Lead; Novartis

Carly Santer

Impact Officer; Bayer UK & Ireland

Michael J. Cohen

Senior Director, Environmental Sustainability, Digital and Decentralized Solutions; PPD


[1] Romanello, M, et al., “The 2022 report of the Lancet Countdown on health and climate change: health at the mercy of fossil fuels”. Vol 400, Issue 10363, 5-11. Nov 2022.

[2] Hannah Ritchie, “Climate change and flying: what share of global CO2 emissions come from aviation?” 2020, Published online at OurWorldInData.org, https://ourworldindata.org/co2-emissions-from-aviation.

[3] US EPA, “Greenhouse Gas Equivalency Calculator,” www.epa.gov/energy/greenhouse-gas-equivalencies-calculator#results.

[4] WHO, “Operational framework for building climate resilient and low carbon health systems,” 9789240081888-eng.pdf (who.int).

[5] Sustainable Markets Initiative, “The Digital Solution for Sustainability in Clinical Research,” https://a.storyblok.com/f/109506/x/42119be232/smi-hstf-digital-health-whitepaper.pdf.

Published: December 2023