Thoughts from the Last Mile Welcome to the VillageReach Blog
08.09 2016

Emerging Threats, Emerging Technologies: The Need for Evidence

As a global health innovator, VillageReach invests great time and effort in exploring how new technologies can be applied to address existing heath systems challenges. Often, this means considering how health system improvements can be leveraged to solve more than one problem at a time. Take, for instance, the emerging Zika virus threat: while VillageReach does not coordinate emergency disease response, our work improving routine transport of medical commodities could be used to strengthen emergency efforts. Similarly, emerging and innovative technologies, such as unmanned aerial vehicles (UAVs, commonly referred to as drones) could add to this comprehensive approach to healthcare improvement.

IMG_2281 v2Working with new partners and new problems allows us to expand our thinking around these innovative technologies. We’ve recently returned from a co-creation workshop convened by USAID where donors, technology providers and global health agencies gathered to discuss the application and potential impact of UAVs in the response to Zika and other emerging threats. While we did hear about proposed strategies for targeting specific disease vectors (mosquitos), one common thread ran through the discussions with which VillageReach is quite familiar: the essential role of reliable routine systems in supporting emergency disease response.

With the additional capabilities and opportunities of UAV technology, this approach could be game-changing. UAVs have the ability to carry small payloads across terrain that more traditional modes of transportation struggle to cross. They can also transport information, collect geospatial data, and create new connections between rural health centers and central medical infrastructure. Decreased transit time through automated, efficient routes might even have the ability to bypass extensive (and expensive) cold chain requirements.

If implemented correctly, these UAV capabilities could be leveraged for improvement of both routine systems and emergency response.

Imagine that a country invests in a UAV system to transport routine supplies between rural health centers and centralized hospitals. This would mean reliable, scheduled delivery of essential medicines, vaccines, and other commodities, perhaps as often as once or twice a week. It could even include routine transport of biological samples, such as dried blood spots for HIV testing. Once that robust UAV transport system is in place, it could also be used for ad-hoc transport of blood bags for obstetric emergencies or medicines for other immediate needs.

Now, imagine that this country sees the emergence of a disease like Zika or Ebola. More patients arrive at health centers because of increased illness and additional supplies are needed. The UAV system is already in place, personnel are already trained, and processes are already optimized for that country’s logistics and environmental context. Instead of doing one or two UAV supply deliveries per week, the frequency could be increased to three or four, potentially with minimal increase in operational cost. Additionally, available UAVs could be used to transport human and zoological samples from rural areas to more centralized labs for testing. This would drastically reduce the time between sample collection and identification, improving the responders’ ability to contain the emerging threat quickly and efficiently.

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Even with the exciting possibilities UAVs have in the provision of routine or emergency healthcare, there are still many unanswered questions for governments looking to invest in these systems. UAV technology is still in its infancy. The global health community is only beginning to understand how – and if – we should invest in UAV solutions. VillageReach and its partners have taken on the important role of exploring how this technology could be incorporated within existing health systems.  One critical component of this work has been building the evidence base for effective and impactful implementation by analyzing costs of UAV systems versus other ground-based transportation systems.  The results of one of these studies was recently published in the journal Vaccine. As our understanding grows, it is essential to document and share this knowledge for appropriate application of this emerging technology.

UAVs are only one component to consider as part of more comprehensive transport and logistics system improvements that also include reliable ground transport, human capacity building, professionalization of workforces, and improved data collection processes. UAVs certainly have the potential to make health systems more agile, but there is more work to be done. Defining specific use cases for UAV transport allows us to understand the limitations of the current technology and work with innovators to push that technology further. It also allows also us to develop more accurate models and pilot programs to build evidence not only on potential health impact, but also the cost, operational considerations, and community impact of UAV technology. Governments and donors need an evidence base to understand the benefits and challenges of this technology before UAVs are accepted as a proven solution in the global health context. Through our continued research, testing, analysis and contributions to the knowledge base, VillageReach is excited to be part of the global dialogue that will define and shape the application of this new UAV technology, particularly at the last mile.

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