Sustainability is a critical issue across multiple industries, and the healthcare and clinical research sector is no exception. Hospitals and clinical facilities can produce tons of waste alongside carbon emissions. Medical research consumes non-renewable resources at a staggering rate, which can have lasting long-term effects on the environment. Sustainable drug discovery and development is one step toward helping decrease the environmental footprint the health and clinical industry leaves.
Integrating sustainable drug discovery practices enables more innovative and practical solutions that minimize the environmental impact. The demand for new medications and treatments will not decrease, which makes it crucial that the development process is responsible and eco-friendly. This will allow scientists to research and innovate treatments while also reducing the detriment to the environment – which could lead to better health consequences in the long run.
The Environmental Impact of the Healthcare Industry
While medical services are necessary for sustaining and saving human lives, the reality is that the healthcare industry has an impact on nature that can lead to eco-threats. In the U.S. alone, the health sector is responsible for 8.5% of national carbon emissions – both from regular operations and from energy, heating, cooling, and supply chain. Globally, hospitals use as much energy to cool their facilities as 110 coal power plants.
Moreover, billions of dollars worth of drugs end up discarded due to improper packaging. In terms of single-use plastics, hospitals produce over 5 million tons of waste each year – 25% of which is some form of plastic. Plastics can be found in syringes, drug packages, surgical equipment, personal protective equipment, and more.
The necessity of these items and equipment often outweighs the waste. However, research is showing us that there are long-term environmental consequences, leading to the need for more sustainable medical and clinical practices.
Significance of More Sustainable Healthcare
Globally, the healthcare sector is responsible for 4.4% of greenhouse gases. Besides reducing the direct effects of climate change on humans and the environment, mitigating the healthcare sector’s negative impact could reduce the costs of care. Per the World Health Organization, the direct damage costs to health could reach $2–4 billion a year by 2030. Hospitals and clinical production facilities being able to reduce their carbon footprints, could drastically bring down costs associated with global health.
Additionally, climate change has the potential to impact health in a variety of ways. For example, increasingly frequent and severe weather events lead to more food/water/vector-borne diseases, mental health issues, and medical emergencies. Long-term, decreased air quality, and food security can cause further health risks.
Environmental degradation can have a significant impact on the healthcare industry’s ability to deliver safe and effective care worldwide. Issues such as hospital evacuations and power outages, medical supply shortages, and other disruptions, in turn, worsen the quality of care provided.
Reducing the carbon footprint of the medical industry could lead to dramatic improvements in overall human health, alongside notable social and economic benefits. “Greenifying” single-use plastics would also mean less plastic produced and discarded and could pave the way for more affordable alternatives.
Lastly, a shift in drug development to more sustainable and eco-friendly processes in both discovery and testing could minimize the environmental impact.
Sustainable Drug Discovery: An Overview
“Sustainability” as a concept is still widely discussed and debated. It is generally taken to mean meeting the needs of the present without compromising the needs of the future, and without compromising the planet’s boundaries and limitations. That partially translates to ethical and “green” practices.
The pharmaceutical and biotech industries are beginning to shift towards these practices to reduce environmental stress on the planet. However, this is a complex and nuanced process – or rather, several processes – since there exists no simple checklist of solutions. Instead, there are initiatives that improve circumstances or mitigate the current negative impacts.
In Volume 12 of Medicine in Drug Discovery, Evelien Wynendaele, et. al. proposed 10 principles of sustainability as applicable to the process of drug discovery. These principles are intended for scientists and healthcare professionals to reflect on their current research and development practices, and consider where they may take a more eco-friendly approach.
#1 — Ecological-environmental impact
This principle is also called “benign by design,” and means that the drug development process should have a minimal environmental impact from the beginning. This includes everything from discovery to development, distribution, and clinical use.
One way to minimize environmental impact in drug development is sustainably sourcing materials for new drugs. Scientists can use tissue culture technologies instead of possibly-endangered plants. Clinical researchers can also repurpose the waste from one process as materials for another one.
#2 — Medical needs
There are thousands of diseases without therapies approved by regulatory bodies. The “medical needs” principle focuses on meeting these unmet or neglected needs instead of on the profitability of pharmaceuticals. Scientists can repurpose existing clinical data and medical solutions to target these unmet needs in a more sustainable drug discovery process.
#3 — Green Chemistry
There are several principles involved in “green chemistry,” but at its core, it is the use of sustainable chemical processes to synthesize and analyze compounds. Doing so minimizes waste and carbon emissions, and conserves non-renewable resources needed in these processes.
Scientists, for example, can use recombinant DNA technology for enzymes. Other forms of biotechnology and computer-aided design can isolate synthetic pathways, minimizing the organic and non-organic resources used in the process.
#4 — AI and Big Data
Automating different phases of drug discovery and development through artificial intelligence (AI) increases the efficiency of the process. Scientists aim to use AI to accurately predict parameters and results for in vivo testing. This allows them to replicate tests and reproduce results at lower costs and resource consumption. Eventually, the hope is to be able to use AI to reduce the need for animal and human subjects in early phases.
#5 — Root causes
Clinical research works towards addressing the root cause of illness as well as mitigating or relieving symptoms. Conventional healthcare has often been reactionary rather than preventative, and largely targets symptom management instead of cures.
Preventing diseases means less of an environmental impact as it necessitates fewer medications and equipment. Disease is not always 100% preventable, but treating the root cause of a disease would be a more sustainable model than simply addressing several symptoms long-term. The idea is to focus on prevention and root cause versus reactionary treatment.
#6 — Risk and decision models
Besides using AI and computational modeling to predict compound testing, scientists can also use them to reduce the risks inherent in the drug discovery process. As technology advances, the idea is that automation can identify pathways and mechanisms of action and assess the sustainability of each beforehand, allowing scientists to choose the most optimal route.
#7 — Biomarkers and bioinformatics
The use of biomarkers and bioinformatics supports more precise medication, reducing ineffective or unnecessary prescriptions that pose a burden to both patients and the environment. A more accurate diagnosis will mean more accurate treatment alongside the cost-effectiveness and sustainability of medication.
#8 — Cost-effectiveness
The Pharmaceutical industry is highly profitable, leading many companies to focus on the profitability of medication versus its cost-effectiveness and equitable pricing. Social justice in healthcare includes transparency regarding the cost-profit margins, which should lead to equitable and socially-acceptable costs.
#9 — Lean discovery process
Drug discovery processes are non-standardized, which means clinical researchers may not take the most effective and optimal routes. “Lean discovery” means to use fast, efficient, and value-adding methods in drug discovery, with optimized experimental designs. Paring down the drug discovery process to only the necessities is more sustainable than exhausting avenues that will likely not lead to any breakthroughs.
#10 — Responsible research and innovation
Pharmaceutical and biotech companies, alongside academic institutions, have the duty to act responsibly in their research and innovation. They should pursue avenues of research that benefit the public at large, versus ones that are simply profitable. Responsibly selecting novel focal points for medical research prevents unnecessary use of resources and labor.
The “Green Chemistry” Approach to Medical Development
Chemistry in drug development is particularly critical in the fight for more sustainable clinical research practices. The science of chemistry is foundational to the process of designing, testing and delivering medicines and devices. But creating and processing chemicals produces physical and chemical waste, and also needs high energy consumption.
The U.S. Environmental Protection Agency defines “green chemistry” as the “design of chemical products and processes that reduce or eliminate the generation of hazardous substances.” These processes should reduce waste and reduce demand for diminishing resources, and consume less energy. They should also create alternatives to hazardous substances that damage the environment.
Per the American Chemical Society, there are 12 principles to green chemistry. These include:
- Prevention (preventing waste instead of treating it after the fact)
- Less hazardous chemical syntheses (limit the generation of toxic substances in synthetic production)
- Safer chemical design (preserving efficacy while reducing toxicity)
Other principles involve safer solvents and auxiliaries, reduction of derivatives, and design for degradation.
Eco-Friendly Drug Discovery: Looking Ahead
Biotech and pharmaceutical sponsors cannot act alone in shifting towards more sustainable clinical research practices. Contract research organizations (CROs) need to do the same in order to minimize the environmental impact across the entire drug discovery and development processes. It’s become increasingly clear that the healthcare and clinical research sectors cannot maintain their current practices without causing irreparable harm to our planet – doctors and scientists need to be able to solve immediate concerns while still looking at the long-term future.
Vial is a next-generation CRO that leverages technology for more sustainable clinical trials. The company was founded to reimagine the landscape of clinical trials and deliver faster, more efficient results at less cost. If you’d like to receive a proposal from us regarding your study, contact us today!
