While drones may have become novelty toys for many, in one Ugandan district together with the upskilling of local community members to operate the drones, they’re providing a lifeline in delivering HIV medicines to other nearby islands.
Kalangala district is an archipelago of 84 islands; some heavily populated others uninhabited and all thickly forested on Lake Victoria, a great expanse of freshwater shared between Uganda, Kenya, and Tanzania. Among its inhabitants of more than 70,000, HIV cases remain stubbornly high despite concerted efforts over the years to bring Uganda’s overall prevalence rate down.
“HIV prevalence in most of Uganda has really declined over the last 20 years,” said Rosalind Parkes Ratanshi, director at the Ugandan Academy for Health Innovation and Impact. Places like central Kampala are around 7 percent, yet the islands have remained at a very high prevalence rate of around 27 percent.
Without finding ways to overcome the geographic and logistical challenges of the area, eradicating HIV remains an out-of-reach target for Uganda.
Kalangala district’s medical drones project could be a solution. The idea behind the Johnson & Johnson-funded initiative is to transport medicines arriving from the mainland by boat from Bufumira Island to more remote locations in the district by drone. The project aims to assess the effectiveness and impact of drone technology teamed with community-driven care in delivering HIV medications.
As the bottles of medication are carefully loaded into the body of the drone, a small crowd gathers to watch on the other side of the yellow tape marking out the grassy landing strip.
With a gentle buzz, the drone rises, a little uncertainly, into the sky, on its 1.5-meter wings. The precious cargo leaving Bufumira health centre III, in Uganda’s Kalangala district, is critical drug for people living in some of the most far-flung communities in the region. The drone which flew off recently was a pilot for a new project which will now see 20 scheduled flights a month, carrying mostly HIV medicines out to 78 community groups and health facilities across the widely scattered Ssese islands, which have the highest HIV prevalence in Uganda.
The delivery of antiretroviral drugs (ARVs) and healthcare is difficult, weather-dependent, and risky for healthcare workers, as travel into the region is possible only by boat.
“The drones, it’s hoped, which cost about £4,000 each, carry loads of up to 1kg and fly for 150km, will close that last mile,” said Andrew Kambugu, executive director at Makerere University Infectious Disease Institute (IDI).
“Closing the last mile of delivery and ensuring that people living in remote communities have equitable access to modern treatments for HIV is one of the most significant challenges in global health and in Uganda,” he said.
Medical drones can help solve this challenge by safely and reliably delivering lifesaving medications, thereby empowering front-line healthcare workers to allocate more time and resources to performing other essential services, resulting in healthier and more resilient communities.
Uganda’s ministry of health, the Academy for Health Innovation, Uganda, and IDI collaborated on the medical drone’s pilot at Bufumira, which carried ARVs to more than 1,000 people living with HIV.
“The overcoming geographical barriers with technology initiative will ease challenges”, said Henry Mwebesa, Uganda’s director-general of health services, who watched the launch.
“Using medical drones is a huge step for us as a health sector in improving service delivery especially in hard to reach areas. It’s very useful. Once it’s successful we can adopt it for other facilities and replicate it in other places,” he said.
The drones are controlled by locally trained experts who monitor the flight and landing.
“This is exciting. It will ease the transportation of vaccines to our health facilities in those landing sites,” said Jude Matovu, in charge of the Bufumira health center. “So we expect our outpatient department coverage to increase,” he added.
The Uganda Medical Association has welcomed the drones but expressed concern over drug shortages due to inadequate funding. Its secretary General, Mukuzi Muhereza said: “We are welcoming it. It’s very important and it could be a game-changer. It would be nice to see whether it really works with our bad network and connectivity.
“While the distribution and delivery are welcome, the other biggest problem I see is that even other public health facilities get stock-outs even when they can be reached by road. So the stock-outs I don’t think would be because of the transportation or connectivity. The biggest stock-outs are because of the funds,” he said.
“Realistically I think we are not giving enough money to national medical stores to purchase drugs and supplies for every Ugandan that needs it. The biggest change would be if we can enhance the budget and make sure we have what we need to send,” he added.
Other African countries, including Rwanda and Ghana, are also using drones to deliver blood and medical supplies, with the technology estimated to be serving more than 22 million people.
Rosalind Parkes-Ratanshi, adds that the programme will also be an important research opportunity to assess and quantify how effective drones are at delivering medications, data that will help scale drone technology and respond to emergencies.
“Thanks to the support and coordination of our partners, including Johnson & Johnson, this programme will help gather the information and data needed to help make this future a reality, while also helping to deliver life-saving care to people in need,” said Parkes-Ratanshi.