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30th April 2024

The health research system needs to achieve environmental sustainability and fund more research into environmental destruction and health

UKHACC Chair, Richard Smith reflects on a recent meeting on research outputs in environmental sustainability

We have known for four years that the NHS accounts for around 5% emissions of greenhouse gases, but we don’t know the carbon footprint of the health research system. The research community has been slower than the NHS to develop a plan to get to net-zero, but the past week has seen two important steps forward: 25 research organisations have signed a concordat “to reduce and eliminate our own negative environmental impacts and emissions and achieve the transition to sustainable practices”; and the first of what will be a series of meetings was held on “Research Outputs in Environmental Sustainability.”

Research systems are complex, including funders, universities, research institutions, regulators, industry, societies, publishers, individual researchers, and many more. Unlike the NHS there is no unified leadership, hence the need for a concordat, which was described at the meeting as “the seed for regulation.” As well as committing the signatories to eliminating environmental impacts, the concordat commits them to “ensure research and innovation continues to play a critical part in understanding how our planet is changing.” Funding has until very recently been hard to win for research on environmental destruction and health and finding ways to reduce that destruction and the harm it causes. The NHS net-zero plan makes it clear that a great deal of research and innovation will be needed to get the NHS and other health systems to net-zero. Research will also be needed to get the research system itself to net-zero.

The signatories to the concordat include the National Institute for Health and Care Research (NIHR), UK Research and Innovation (UKRI), and the Wellcome together with 10 universities. Funders hold a great deal of power in the research system (no funds, no research) and are beginning to require researchers when submitting grant applications to include information on environmental impact. How, people asked, will they trade off clinical benefit, cost, and environmental impact? The criteria that will be used to make the trade-off are not clear, and nor are their agreed methods for measuring the environmental impact of research. Eventually, it was agreed, funders will have to stump up to develop a tool for measuring environmental impact. Representatives of funders did say that they will be willing to pay more to reduce environmental impact. Eventually funders might have carbon budgets just as they have financial budgets and will be obliged not to exceed their carbon budget, forcing some difficult decisions.

As for the NHS, much of the carbon footprint of the research system will result from procurement—purchasing machines, agents, transport, food, and much more. The NHS is steadily stepping up what it requires from suppliers. Might research institutions be able to come together to use their purchasing power? Similarly, might they come together to lobby government? Academic institutions are jealous of their independence, and Imperial, Cambridge, and Oxford, three big research universities, have not signed the concordat.

Again as in the NHS, there are many pockets of innovation, but there are not good ways of sharing learning. People asked the funders to be willing to fund networks to share learning, and some networks—for example, on measuring and reducing the carbon footprint of clinical trials—already exist.

One message that was emphasised at the beginning of the meeting and then largely forgotten was the importance of including patients, research participants, and citizens in developing programmes to reduce the environmental impact of research. NIHR in particular has led the way with ensuring that patients are involved in every part of the research process, and they must be part of achieving environmental sustainability as well.

The leaders of the research community may have been slow to wake up to the importance of environmental sustainability in research, but when ending the meeting Professor Sir John Iredale, honorary consultant physician and former executive chair at the Medical Research Council, UKRI (who did a good job of chairing the meeting, encouraging candour) emphasised the need for immediacy and system wide change.