October 2026

This report presents the findings of our BIG Clinical Trials Sustainability Survey.

The survey gathered 181 responses from clinical trial professionals across five continents. Respondents worked for sponsors, CROs, investigational sites, laboratories and supply vendors, on both commercial and publicly funded trials. The results show a community that is convinced of the case for change while highlighting the tools, organisational support and practical guidance needed to translate that commitment into action. 

Key findings

  • Clear conviction, lower readiness. 93% of respondents rated environmental sustainability as important (4 or 5 out of 5), but only 41% felt ready to put sustainable practices into action in their own role. Average scores were 4.5/5 for importance and 3.2/5 for readiness. 
  • The gap is widest closest to delivery. Readiness was lowest among CROs and investigational sites (both averaging 2.9/5). Sponsors, who make more of the design-stage decisions, reported a narrower gap. 
  • The barriers are structural, not attitudinal. The most cited barriers were:  
    • conflicting organisational priorities 
    • uncertainty about which practices to adopt and how 
    • difficulty calculating trial carbon emissions 
    • sustainability not being part of trial designers’ goals and objectives 
  • Waste is a frontline frustration. Excess supplies sent to sites was a recurring theme, particularly among site-based staff. 
  • More practical training is needed. Respondents want practical, applied content, delivered mainly through their own organisations. 
  • Change is often driven by individuals. 67 respondents shared examples of sustainable practice, such as consolidating sample shipments, going paperless and redistributing unused kits. Many described working as lone “sustainability champions” without a formal organisational mandate. 

What needs to happen next 

The report sets out four areas of focus for the clinical trials sector: 

  1. Set sustainability objectives from the top down, so progress no longer depends on voluntary effort. 
  1. Build sustainability into trial design and decision-making from the start. 
  1. Make sustainability a routine part of trial delivery through shared measurement standards and practical guidance. 
  1. Support people with role-relevant, easy-to-access training. 

“The message from the clinical trials community is clear: people care deeply about reducing the environmental impact of their work, but too often they’re being left to do it alone. We can’t rely on the goodwill of individual champions to deliver the change our sector needs. Sustainability has to be built into trial design, embedded in every role and backed by leadership. This report shows exactly where that support is needed most, and we hope organisations across the trials ecosystem will treat it as a shared call to action to make clinical trials ‘Sustainable by Design’.” 

Fiona Adshead, Chair, Sustainable Healthcare Coalition


The Coalition will use these findings to shape its ongoing programme of guidance, tools and community-building for the clinical trials sector. We would like to thank the 181 professionals who took part, the industry Low Carbon Clinical Trials (iLCCT) consortium, and members of the Sustainable Clinical Trials Community of Practice and partner organisations who helped distribute the survey. 

Click here to access the report in full

Media contact
Joanna Bell, Programme Lead
[email protected]