How We Can Achieve Environmental Sustainability in Clinical Research

Written by:
Clare Campbell-Cooper, Global Head, Digital Health and Innovation at Fortrea
Michael Cohen, Senior Director, Environmental Sustainability at Thermo Fisher Scientific

Note: Campbell-Cooper and Cohen serve as co-chairs of the ACRO Sustainability Committee.

Earlier in 2025, ACRO’s Good Clinical Podcast (GCP) launched its third season with a compelling question: How can clinical research reduce its environmental footprint while driving progress? Guests Clare Campbell-Cooper and Michael Cohen shared strategies for improving sustainability practices across the drug development industry. Here, Clare and Michael dive deeper, connecting themes from their episode to bigger questions and possibilities. Continue reading to learn from industry experts on the ideas shaping the future of environmental sustainability in clinical research. Want the full context? Start by listening to their original episode by clicking on the podcast player above.

The clinical research industry has a unique responsibility to push healthcare forward, requiring a delicate balance between medical innovation and environmental sustainability. This is because human health and planetary health are inextricably linked, and so, advancing one to the detriment of the other is a fool’s errand. Being part of making clinical trials more environmentally sustainable is both a privilege and an exciting opportunity. We have the chance to make a difference, starting now. In fact, starting yesterday.

Sustainability means eliminating waste in the clinical trial process: from team hours to duplicative processes to streamlining the clinical supply chain.

Being a clinical research organization (CRO) comes with unique challenges. We aren’t a manufacturing company with clear inputs and outputs. We are consultants, project managers, innovators, practitioners, and medical professionals guiding the strategy and operations of clinical trials. We can’t merely come out with a new recyclable widget or just start composting leftover food. In the end, our product is data. And data processing requires energy.

The emissions emanate from the process that delivers that data. Beyond the data, CROs work with physical locations, phase 1 clinics and offices, as well as people — notably, clinical research associates who travel often — that present opportunities to make sustainable choices and find efficiencies.

Much of our business strategy is determined by listening to and anticipating sponsor needs. That is why the open letter to the clinical trial community, published by members of the Sustainable Markets Initiative (SMI) Health Systems Task Force — including CEOs of AstraZeneca, GSK, Merck, Novo Nordisk, Novartis, Sanofi, and Roche — holds so much promise for CROs. It signals a powerful call to action to place sustainability at the forefront of our initiatives and embed it deeper into our cultures. It validates our desire for a more environmentally efficient project lifecycle.

This isn’t just relevant for large pharma; it also helps biotechs and smaller companies. Why? Because sustainable processes are efficient ones. Sustainability means: eliminating waste from team hours to duplicative processes to streamlining the clinical supply chain.

Designing trials with sustainability in mind from the start facilitates more efficient trials for sponsors, CROs, sites, patients, and the planet.

It can deliver cost savings, resulting in fewer patient visits and leading to better engagement.

In July, we worked with ACRO to establish the ACRO Sustainability Committee for CROs and clinical technology companies with global representation. Planet prosperity transcends competition, and bringing together like-minded individuals who are passionate in this space will help shape our industry for the better. The ACRO committee brings together representatives from many areas of the business, including technology, IT, ESG, and other critical functions across member organizations.

CROs have increasingly reported growing interest from many sponsors who themselves are committing to more sustainable businesses and therefore want to understand what our companies are doing to reduce the environmental impact of clinical trials. This in and of itself, is a major step forward, but it is not without its challenges, as each request for information, proposal, and vendor qualification asks slightly different questions. To address this, the committee hopes to develop a standardized list of questions that summarizes common sponsor inquiries so that we can provide like-for-like information on sustainability. This would enable CROs to provide consistent, comparable information while streamlining resources.

To reach net-zero by 2050, in line with the Paris Agreements, we must not only measure our emissions but also take significant steps to reduce emissions.

Transparency is key to progress. That is why we welcome the Sustainable Markets Initiative’s Low Carbon Calculator and are collaborating with the Sustainable Healthcare Coalition to provide further data to strengthen how this is used.

Another opportunity presents itself here: how, as CROs, do we apply these models consistently to ensure sponsors receive normalized, comparable data? And when, as an industry, do we complete the calculator during the study process? Models are only as good as the integrity and quality underpinning the collection process. We hope to make certain that the output from the Carbon Calculator is beneficial to the industry and provides a solid benchmark for us to track improvement.   

The letter from the SMI Taskforce was a clear call to action, but it focused on completing the iLCCT Clinical Trial Carbon Calculator, a tool that many CROs are already utilizing. While the letter points in the right direction, it focuses on approximating the carbon emissions through the models.

To reach net-zero by 2050 in line with the Paris Agreements, we must not only measure our emissions but also take significant steps to reduce them.

Some pharmaceutical companies have established near-term, absolute Scope 3 reduction targets by 2030, which aim to reduce indirect greenhouse gas emissions from the entire value chain (Astra Zeneca, Takeda, Gilead, Boehringer Ingelheim, Bayer (2029), Merck KGaA, Teva, Otsuka, Viatris, Astellas, Glaxo Smith-Kline, Lundbeck, Merck MSD, Novartis, Sanofi, amongst others).

This means that clinical trials starting now may very well run into Scope 3 goals published by pharmaceutical companies. Therefore, we are already out of time to attempt to measure emissions. We need to start decarbonizing.

There is a burgeoning but tremendous literature[1] reviewing the carbon footprint of clinical trials. This literature shows that key areas such as investigational product/comparator, patient travel, investigator meetings, monitoring visits, and site utilities drive emissions and represent so-called “hotspots.”

We hold that carbon emissions models can illuminate which areas to focus on for reductions, and what to push CROs on, in terms of emissions reductions.

We believe that CROs and clinical technology companies play a pivotal role in increasing planetary prosperity and health equity, and we look forward to partnering with our sponsors and other interested parties in building a more sustainable future for clinical trials.

[1] LaRoche JK, Lanier J, Alvarenga R, et al.  Climate footprint of industry- sponsored in- human clinical trials: life cycle assessments of clinical trials spanning multiple phases and disease areas. BMJ Open 2025;15:e085364. doi:10.1136/ bmjopen-2024-085364