Life cycle assessment of a clinical malaria trial in Mali reveals large environmental impacts of electricity consumption and international travel

Climate change may be the single largest threat facing humanity and ecosystems, necessitating reductions in carbon emissions across all sectors, including healthcare and academia. With the aim of informing and supporting sustainable research practices, we performed a life cycle assessment of a clinical malaria trial conducted in Mali. The trial involved 80 malaria-infected participants in Ouélessébougou who were treated with antimalarials and monitored to determine clinical and transmission-blocking efficacy. Data on consumables, transportation, travel, and electricity use were collected in Mali and the Netherlands, where additional laboratory analyses and sample storage occurred. Data were analysed using the ReCiPe 2016 method for midpoint impact assessment. The trial involved 3 intercontinental shipments of materials and samples, 59,900 km of travel by research staff, and ~55 kg of plastic consumables. Trial conduct and reporting resulted in approximately 20.5 metric tons of CO 2 -equivalent (CO 2 e) emissions. Major carbon contributors were international travel (50%), electricity in Mali (28%), and air-transportation of materials (14%). Laboratory consumables, while contributing up to 20% of the trial’s impact on land and water use, were less important sources of emissions (2% of CO 2 e). The formation of fine particulate matter was another important contributor to human health damage, which was mainly attributed to electricity in Mali. Main contributors to ecosystem damage were carbon emissions, terrestrial acidification and ozone formation, with electricity in Mali and international travel as the two major contributors. With an eye on energy efficiency and sustainability, we observed no loss in stability of parasite genetic material (mRNA) in protective buffers when stored for 12 months at -20°C, compared to conventional -70°C. Switching to energy-efficient equipment settings could reduce electricity consumption of equipment by over 30%. Implementing solar panels could reduce overall CO 2 e emissions substantially. Immediate CO 2 e reductions can further be achieved through online conference attendance and alternative sample transportation; the latter would allow 10% CO 2 e emission reduction. These results form a starting point for improving the environmental sustainability of clinical trials in Africa.