Crossing the Last Mile: Delivery Systems

After the surge in medical technological advancements brought on by the COVID-19 pandemic and shift toward digital innovations in healthcare, we may find ourselves asking, what’s next?

Clearly, healthcare will only continue its march toward greater digitization and automation.  Specifically, we may be on the cusp of a much wider application of unmanned aerial vehicles, or drones, to address access gaps across the world, starting with the global health’s biggest intervention – the Expanded Programme on Immunization, or EPI.  EPI was launched in 1974 building on the success of the smallpox program and was designed to be a scaled-up effort to ensure that all children in all countries could benefit from life-saving vaccines. With WHO and UNICEF publishing this past May the findings that nearly 50 million children have missed out entirely on vaccination over the past three years of COVID-19 – the biggest gap since EPI was started – global partners are looking for innovations to get vaccines into arms quickly and at scale around the world, particularly in remote, hard to reach communities.  

Drones are devices once seen as children’s toys or government tools. They are omnipresent in the news now around Russia’s invasion of Ukraine as they are used on an unprecedented scale to conduct reconnaissance missions, support ground troops and strike enemy operations. For some years now this technology has been used in the healthcare setting for the delivery of medicines and supplies to remote destinations but this medical function is now getting more attention as the world looks to deliver more products at lower costs.  Wider availability of supplies, including samples for testing, can be crucial in combatting deadly communicable diseases, reaching geographically complex, remote areas, and helping rescue efforts during natural disasters. range from being remotely piloted (a person controls the drone’s movements with a remote) to more autonomous vehicles relying on programs and sensors. Drones have varying ranges and can travel at different heights depending on the model. This makes them ideal for battling tough terrain. This has created major innovations in many fields, including photography.

Drones are slowly being incorporated into the healthcare setting with a very promising future. In Malawi, they are being used to carry medical supplies to nearly 20 million people. Rwanda made history as the first country in the world to use drones to deliver blood and medications to rural hospitals. Drones are being used to access remote locations in the Democratic Republic of Congo to fight Ebola and other infectious diseases, limiting the risk of spread.

During natural disasters, such as major flooding, where emergency vehicles are not able to gain access, drones can make the difference between life and death. Not only can their video camera technology assist rescue efforts by mapping out the extent of the damage and location of survivors, but they are able to fly over the complex terrain that limits ground-based rescue vehicles to deliver medications and other medical supplies.

The presence of drones will increasingly be one that we see outside of emergency situations. They not only help with remote access but are also able to generally increase the efficiency of delivery globally. Drones are a more cost-effective and environmentally method of transportation. ¹

Returning to our present-day crisis in global immunization, drone delivery of vaccines would seem one obvious solution. But glass vials, which are the current standard packaging for vaccines, are not well suited for use in drones because of their weight and breakability. Plastic pre-filled syringes, in comparison to glass-cased medical products, reduce breakages and improve delivery due to their lightweight nature. This combination leads to a more cost-effective and efficient delivery system. Years of innovation have meant that pharmaceutical protein and drug products have been approved for plastic syringes, they can be used in situations where glass syringes are not appropriate. These situations coincide with those in which drones are essential, such as delivery to areas that are difficult to access.

Although drones seem like the ideal solution to access problems, they do come with challenges. While new technology has made drones more accurate and easier to use, they are still complicated technologies relying on accurate geolocation, trained users, and have limitations on payload, battery life, and distance coverage. There is also a major concern regarding privacy and legal use of drones as they cross private areas and record their progress. Getting legal permission for specific routes and deliveries can be complicated as well.

For these and other reasons, it is clear that drone delivery is not going to replace conventional transportation methods in global health in the immediate future. However, it is also clear that conventional delivery approaches are failing us in some critical places. Finding solutions that will enable better access to life-saving vaccines and drugs, particularly in the case of remote, underserved communities and natural disasters will be, essential for the evolution of equal access to essential healthcare.

1. There is a growing amount of data on the use of drones in health care and other related industries.  For more reading on this, please see:  BMC article: drone vs ambulance in blood transportation, drones are more expensive per minute but are significantly faster which offsets the cost https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-07321-3

Pubmed article: when used for vaccine delivery the drones save 0.08 USD per vaccine https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5547752/

Science direct article: reduced carbon emissions by 24.90%, reduced total cost by 22.13%, and shortened delivery time by 20.65%

https://www.sciencedirect.com/science/article/abs/pii/S0959652623009162#:~:text=The%20results%20show%20that%20compared,and%20carbon%20emissions%20are%20compared.