Drones have transformed blood delivery in Rwanda

Six years ago, there was a blood delivery problem. The small East African country has more than 12 million people and they get into car accidents. New mothers are bleeding. Anemic children need blood. You can't predict emergencies. The red stuff in Place A has to find its way to a patient in Place B.

If you live in a city, that isn't a big problem. In the United States and the United Kingdom, 80% of the population is clustered around high-traffic hospitals and blood banks. Most of the population in African nations live in cities. 83 percent of the people in Rwanda live in rural areas. When remote hospitals needed blood, it came by road.

That is not ideal. The country is not flat. The roads can be rough. If kept cool, donated blood can be stored for a month or so, but some components that hospitals use for transfusions won't last long. It's not a good match for a turbulent drive.

That logistics issue historically incentivized rural facilities to order more blood than they needed. “There was a problem of overstocking,” says Marie Paul Nisingizwe, a PhD candidate in Population and Public Health at the University of British Columbia, who focuses her research on Rwanda, her home country. Stocking a little extra could save time later. But if a low-traffic facility didn’t wind up using the blood before it expired, they'd have to dump it.

Zipline, a San Francisco-based drone startup, was contracted by the government of Rwanda to streamline blood deliveries. Zipline's drones would fly blood from a distribution hub to a health care facility. The blood, contained within an IV bag, would be dropped in a cardboard box by a drone. Zipline can make up to 500 deliveries per day in Rwanda.

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For the first time, there is proof that drone blood services improve delivery speed and reduce waste. In the April issue of the Lancet Global Health, Nisingizwe analyzed over 12,000 drone orders and found that half of them took less than 40 minutes to deliver. The median time on the road would be at least two hours. There were reports of wasted blood donations.

The study is the first of its kind. It is amazing to see that delivery drones are feasible in African settings, where they are more common in higher-income countries. Her research team is not affiliated with Zipline.

It's so good. Timothy Amukele, a pathologist who is not involved with the research team or Zipline, says that it is good for the country. Amukele is the global medical director for ICON Laboratory Services, which helps run clinical trials. The promise of drones for global medicine has been talked about for years, but there is no concrete data to back it up.

He says that drones are not easy to use and that they need blood and packing it safely to make this a success.

The country has a reputation for leaning into health tech innovations. Rwanda has a universal health care system that covers 90 percent of the population. In 2009, the government piloted a phone-based program to track and reduce maternal and child mortality. RapidSMS connected 15,000 villages to the country's wider network of doctors, hospitals, and ambulances.

Michael Law, Nisingizwe's adviser and a health policy researcher at the University of British Columbia, says that they have one of the most complete electronic data systems. That is a gold mine for researchers like Nisingizwe, who want to measure how much innovation helps.