Vishnupriya
To make trials more environmentally friendly, we first need to understand their carbon footprint and identify the major sources of emissions. With colleagues from the University of Liverpool, we received funding from the National Institute for Health and Care Research (NIHR) to develop a method and guidance for carbon footprinting publicly funded clinical trials.
Recently, we also received funding from Wellcome to create an online, open-access database of trial activities and carbon emission factors, together with an associated carbon calculator tool and resources for mitigation strategies for publicly funded trials and trialists.
What have you seen change since using the toolkit?
To date we have footprinted 12 publicly funded trials using the method and guidance. We’re working on collating much more clinical trial data and this includes international collaborations with colleagues in France and South Africa who are adapting the toolkit for use in their countries.
Although the current sample is small, we are beginning to identify important trends. The ‘hotspots’ of emissions vary between trials, indicating the need for a case-by-case approach. Common sources of emissions include the operations of the Clinical Trials Unit (CTU) or sponsor, travel for the trial staff, and patient travel and assessments. These areas are potential targets for reducing emissions in future trials. Additionally, emissions can arise from associated processes and collaborators, such as central laboratories, data science, and long-term storage of records or samples.
At The Institute of Cancer Research Clinical Trials and Statistics Unit (ICR-CTSU) (ICR-CTSU), we are incorporating carbon footprinting into the development stage of new trials and including this information in funding applications wherever we can. By highlighting the carbon footprint to the trial team and funders, we aim to raise awareness and encourage more sustainable practices.
What advice would you give to trial managers adopting more sustainable practices?
Addressing the environmental impact of clinical trials requires coordinated efforts across sectors. We are collaborating with Greener NHS, industry (via the Sustainable Healthcare Coalition industry Low Carbon Clinical Trials group, the iLCCT), funders, patients, policy makers and regulators to align our work. We are also developing tools and resources to make carbon footprinting easier and quicker for publicly funded trialists.
Currently, there are several resources available, which we are compiling on the MRC NIHR TMRP Greener Trials website. These include the NIHR’s carbon reduction guidelines, the UK CRC Monitoring Group’s Greener Monitoring Guidance, the UKTMN Guide to Efficient Trial Management – which has a chapter on sustainability – and our papers describing the carbon footprinting method and guidance. I encourage trial managers to utilise these resources and contact the Carbon in Clinical Trials team for further support or information.
What does the future hold for tools like this?
We are working on building an online toolkit which will be open science, referenced, annotated and free to use. We hope that the toolkit will help calculate the footprint of trials and provide advice on how to reduce the impact of the hotspots identified. We will work hard to align this tool with parallel initiatives ongoing in the pharmaceutical industry, internationally and within the NHS.
