Introduction
Rwanda faces unique challenges in healthcare delivery due to its mountainous terrain and limited infrastructure. Many rural communities are isolated, making it difficult to access essential medical supplies and services. But over the past few years, Rwanda has emerged a leader in the use of drone technology for medical logistics, showcasing how innovative solutions can address critical healthcare challenges in low-resource settings. Since 2016, Rwanda has partnered with Zipline, a California-based drone delivery company, to transform how medical supplies are distributed across the country.
Application of Drones in Rwanda’s Healthcare Sector
First started as alternative transport for blood products to rural facilities located in difficult terrain, the use of drones has since expanded to include delivery of medicines and cold chain commodities such as vaccines. The programme began as a pilot project with the establishment of a distribution centre in 2016 in Muhanga, approximately 45 kilometres from Kigali. The centre now serves as a hub, coordinating the delivery of blood, vaccines, and other critical medical supplies to over 1,000 health facilities across the country in 2023 (Zipline, 20231).
Zipline's drones are equipped with advanced GPS and autopilot systems that enable autonomous flights. Health facilities place orders through SMS or a mobile app. From any one of its bases, Zipline drones can deliver commodities to a facility within an hour (Ministry of ICT2).
Rural health facilities have greatly benefited from this technology. These were facilities that could only be served by motorbikes or refrigerated trucks on poor roads, which could lead to delays and put lives at risk, especially in emergencies. In some cases, the facilities experienced limited cold storage and could only stock small quantities of blood stock. In 2022, the Government of Rwanda expanded the partnership with Zipline, to expand geographical coverage and products delivered, to include nutrition and animal health products (Techcrunch, 20223).
Policy and Regulatory Framework
The utilisation of drones in the Rwanda health sector has been made possible by a supportive policy environment. The 2018 – 2024 Fourth Health Sector Strategic Plan prioritizes integration of e-health initiatives to improve the reach of the health system for people cut off by geographical barriers. The country also established a drone regulatory framework, involving stakeholders including the Ministry of Health of Rwanda, Rwanda Civil Aviation Authority, Rwanda Development Board, and Rwanda Biomedical Centre (Jeon et al, 20224). The Rwanda Information Society Authority (RISA5) has also established a Drone Operation Centre, whose mandate is to create a supportive environment for Rwanda to become a global leader in drone technology and innovation.
Impact
By 2020, Zipline was delivering blood to 25 hospitals and clinics across the country every day6. This increased access significantly improved emergency response times and patient outcomes. One study found that between March 2017 and December 2019, nearly 13,000 blood product orders from facilities had been delivered by drones, with about 43% of the orders being for emergency supply (Nisingizwe et al, 20227).
In addition, using drones optimised distribution and within a year, contributed to a significant reduction in the proportion of damaged or expired blood stock in the facilities. According to the research by Jeon et al in 2022, improved blood delivery also contributed to a nationwide reduction in in-hospital mortality from postpartum haemorrhage by as much as 51%. The inclusion of veterinary drugs in the commodities delivered by drones in 2022 is credited with the rapid deployment of livestock vaccines to affected regions during the Rift Valley Fever outbreak, and making it possible to maintain the cold chain (Ishema et al, 20248).
Lessons Learnt
Rwanda is a good example of how to integrate drone technology in medical supplies logistics in a resource-constrained health system. Other countries can adopt the lessons from Rwanda to overcome logistical challenges and improve access to healthcare services:
a) A supportive policy and regulatory framework are important: Rwanda put in place the necessary policies and reviews of existing regulations, such as the laws on civil aviation, to support the integration of drones in healthcare services. The government also included, as a priority, the integration of emerging technologies in health services in its strategic plan for the health sector.
b) Piloting provides useful lessons before wider scale-up: In Rwanda, Zipline introduced drones in one district to begin with. The introduction to other regions has been gradual, over time.
c) Government support can lead to faster adoption of innovations: The Government of Rwanda has been a partner in the drone initiative right from the beginning. This support created the right opportunities for Zipline to roll out the technology without bureaucratic hurdles. Partnership with the private sector firm also helped, bringing in the technology and technical expertise.
d) Emerging technologies ride on good infrastructure and a thriving digital culture: Rwanda has over the years invested heavily in digital infrastructure, with extensive, high calibre internet connections and well-established mobile phone use. This extensive digital infrastructure supported the rapid roll out of the drone system, and the familiarity and widespread use of mobile phones led to the rapid acceptance of the drones as a critical part of the healthcare system.
Conclusion
Rwanda's pioneering use of drones to enhance medical logistics exemplifies how emerging technologies can transform healthcare delivery, particularly in resource-constrained environments. As Rwanda has shown, drones have a wide range of potential uses and can support traditional logistics systems, taking advantage of their speed and versatility. With thoughtful investments and the right policies and incentives, African countries can harness this rapidly evolving technology for massive gains for their populations.