Six years ago, Rwanda had a blood supply problem. More than 12 million people live in the small East African country, and just like in other countries, they sometimes get into car accidents. New mother’s bleeding. Anemic children need urgent transfusions. You cannot predict these emergencies. they are just to happen. And when they do, the red stuff stored at site A must quickly find its way to a patient at site B.
That’s not a big problem if you live in a city. In the United States and the United Kingdom, 80 percent of the population clusters around urban hubs with crowded hospitals and blood banks. In African countries such as Libya, Djibouti and Gabon, about 80 to 90 percent of the population also lives in cities. But in Rwanda that number is about to change: 83 percent of Rwandans live in rural areas. So traditionally, when remote hospitals needed blood, it came by road.
That’s not ideal. The country is mountainous. Roads can be hot, long and bumpy. If donated blood is kept cool, it can only be kept for a month or so, but some components that isolate hospitals for transfusions, such as platelets, will spoil within days. A turbulent ride is not a perfect match for such a finicky load.
That logistical issue has in the past encouraged nationwide facilities to order more blood than they need. “There was an oversupply problem,” said Marie Paul Nisingizwe, a PhD candidate in Population and Public Health at the University of British Columbia who focuses her research on her home country of Rwanda. Stocking up on a little extra can save time later. But if a low-traffic facility wasn’t going to use the blood before it expired, they’d have to dump it.
In 2016, the Rwandan government signed a contract with Zipline, a San Francisco-based drone startup, to streamline blood deliveries. Zipline’s autonomous drones would fly the blood from a distribution center to the healthcare facility. The blood, which was in an IV bag, would parachute down into an insulated cardboard box and the drone would zip back. Today Zipline has two hubs in Rwanda; each can make up to 500 deliveries per day.
And now, for the first time, there is evidence that drone blood services improve delivery speed and reduce waste. Writing in the April issue of Lancet Global Health, Nisingizwe analyzed nearly 13,000 drone orders between 2017 and 2019 and found that delivery of half of the orders took 41 minutes or less per drone. On the road, that average time would be at least two hours. Reports of wasted blood donations dropped.
The study is the first to analyze medical delivery drones in Africa. (Drone programs are more common in higher-income countries, where they are used to deliver drugs and defibrillators.) “It’s amazing to see that the delivery drone is really feasible in African environments,” says Nisingizwe. (Her research team is not affiliated with Zipline.)
“To be So good. And it’s not just good for Rwanda,” said Timothy Amukele, a pathologist not involved with the research team or Zipline, but who previously led a medical drone group with projects in Namibia and Uganda. (Amukele is currently the global medical director of ICON Laboratory Services, which helps conduct clinical trials.) Drone applications for global medicine have been touted for years, but researchers have no concrete data to back that promise, Amukele says: This is more than just boys playing with toys.”
“Drones are not easy,” he continues. “To really make this a success, where they get blood and pack it safely and release the drones and monitor the flight and bring it back — and cover 80 percent of that country for five years — it’s just really impressive.”
Don’t be fooled by Rwanda’s rural demographics; the country has a reputation for leaning on innovations in health technology. Rwanda’s universal health care system reaches more than 90 percent of the population. In 2009, the government launched a phone-based program called RapidSMS to detect and reduce maternal and infant mortality. In 2013, RapidSMS connected 15,000 villages to the country’s wider network of doctors, hospitals and ambulances.
“They have one of the most complete electronic data systems,” said Michael Law, Nisingizwe adviser and health policy researcher at UBC, which helps Rwanda’s Ministry of Health keep track of how many people see doctors, how many people have malaria or HIV, and how many give birth in health care facilities. . That is a gold mine for researchers like Nisingizwe, who want to measure how much innovation helps. “Honestly, we couldn’t have done this evaluation if they hadn’t installed the data system,” Law says.