SAN FRANCISCO — Unmanned aerial vehicles are carrying blood and other lifesaving medical supplies over Rwanda’s hilly landscape. These fixed-wing aircraft are engineered by Zipline, a company based in California, which recently expanded from Rwanda to Ghana.
Donors and NGOs are experimenting with drones to deliver on global health, development, and humanitarian response priorities. But regulations and coordination still lag behind. Devex is asking what role development actors can play in ensuring safe, sustainable use of this promising tech.
When hospitals place an order, workers at fulfillment centers wrap the supplies, place them in boxes, then load them into drones that follow a predetermined flight plan to their destination.
On Friday, Zipline announced it has raised $190 million in new financing, which values the company at $1.2 billion.
After launching in Rwanda, the company initially announced it would expand to Tanzania, but the deal fell through in contract negotiations with authorities. While Zipline’s first contract with the government of Rwanda was confidential, the financials of its new contract with Ghana are public and have generated some controversy. Critics have called it a vanity project, questioning whether drones are a smart investment for global health delivery, and saying the money should go to other priorities such as clinics and ambulances.
Zipline, which counts not only Silicon Valley investors but also the Bill & Melinda Gates Foundation, UPS Foundation, and Gavi, the Vaccine Alliance, among its supporters and partners, finds itself at the center of a debate about the role that donors should and should not play in medical cargo drones for global health.
Amid the ongoing discourse, experts tell Devex donors should focus on ensuring competition for contracts, building local capacity for medical cargo drones, and supporting safe regulatory environments that drones for delivery require to succeed.
Competition for contracts
UNICEF recently worked with Vanuatu to put together a competitive bidding process to deliver temperature-controlled vaccines throughout the island nation. More than 20 companies offered their services, said Jaime Archundia, global drones lead at UNICEF.
“A really key message is the need for Western donors to create equal opportunity around the use of drones, and not to simply contract companies from their own countries all the time.”— Patrick Meier, founder, WeRobotics
Ultimately Swoop Aero, an Australian startup, won a contract to serve three islands. Now, villages that were reachable only by banana boats are receiving vaccines from drones.
“It is important to test with a range of providers first and avoid situations where you start with a specific company and that company is not able to deliver,” Archundia said.
PATH, a nonprofit global health organization, learned about the importance of competitive bids from a project testing how drones might provide two-way delivery and retrieval for an island community in Senegal.
The plan was to provide medical supplies that ran out between regular stock deliveries, or urgently needed supplies such as blood and snake antivenom, while also transporting lab samples back, said Joanie Robertson, a senior program officer at PATH who leads its work on drone technology for health supply chains.
But while the drone manufacturer for the project was selected through the Gates Foundation Grand Challenges Explorations process, it was not able to demonstrate the technical feasibility of the drone to the regulatory agency, so the project has not moved forward.
Zipline is one of only a handful of examples of long-term partnership between a government, a donor agency, and a drone service provider, but it also has a first-mover advantage, making it difficult for other drone companies to break in and compete.
The typical pattern for donors and NGOs that seek to bring drones into their work is to partner directly with a provider. “I’m not an engineer,” said Scott Dubin, warehousing and distribution team lead at Chemonics. “Asking what you look for in a drone takes a lot of research.”
To make it easier for organizations that want to put together a competitive bid or tendering process, he and his team developed a UAV procurement guide outlining questions that organizations should ask when putting together requests for proposals involving the use of cargo drones.
Last month, at a Drones for Social Good Summit hosted by UNICEF in New York City, Dubin talked about his upcoming work in Malawi exploring the bidirectional use of UAVs to and from hard-to-reach health facilities. Ultimately, Chemonics went with Wingcopter, a company based in Germany, as the service provider for their project.
But as the list of projects on cargo drones for public health grows, some question whether it makes sense to continue to fund smaller scale projects for specific use cases, like HIV/AIDS supplies.
There is little value in “a country repeating exactly the same use case with exactly the same donor funding without really any sense of what they're going to do next,” David Sarley, a senior program officer at the Gates Foundation who focuses on innovation for immunization, said.
The Gates Foundation is one of a number of donors participating in an unmanned aerial systems coordinating body, part of the Interagency Supply Chain Group, a forum to share what is and is not working in UAVs for health.
Building local capacity
One of the key areas of focus in an online course on medical cargo drones in public health is building local capacity and ownership.
“A really key message is the need for Western donors to create equal opportunity around the use of drones, and not to simply contract companies from their own countries all the time,” said Patrick Meier, founder of WeRobotics, which helps local communities use robotics for good and organized the course.
In a project with the Centers for Disease Control and Prevention in Papua New Guinea, WeRobotics partnered with Redwing Labs, an Indian startup, rather than going with better-known companies such as Swoop Aero or Wingcopter.
This month, WeRobotics is launching three different cargo drone projects with three flying labs in three countries, and capacity building and technology transfer is central to each of the projects, Meier said. The hope is that over time, fewer countries will have to look beyond their borders for drone expertise.
Critics of Zipline have expressed concerns that companies doing their testing in developing countries might leave as soon as new and more profitable markets open up. One safeguard is that drone companies, like any private companies that get donor support to work in developing countries, would get negative publicity if they pulled out of these markets, Sarley of the Gates Foundation said.
The U.S. Agency for International Development developed a report on UAVs in global health identifying some of the most promising UAS use cases, including delivery in response to medical emergencies, “just in time” resupply to prevent stockouts, and the two-way transport of samples and treatments.
Beyond these use cases, drones could risk creating opportunity costs — including disincentives for governments to invest in providing access to basic public goods and services.
Brittany Hume Charm, head of global partnerships at Zipline, stresses that the use of drones for global health supply delivery is about more than the price tag, considering the speed and efficacy of delivery.
"The reality is what you get in the status quo, versus a system like Zipline, is very different,” she said.
Governments have an obligation to deliver these services, whether through the public sector or private sector, in partnership with one company or several, via truck or by drone, Hume Charm said.
She emphasized that while Zipline is in talks with many countries, at this stage it is only in Rwanda and Ghana, and said she agrees it is in the “best interest of global health systems” to invite more competition.
Peter Rabley, a venture partner at Omidyar Network, can make both grants and investments from this philanthropic investment firm, but while he has provided a grant to WeRobotics, he said he estimates he has passed on 50 pitches for investment in drone companies.
“What donors are good at, and should focus on, is passing proper regulatory environment that allows the stimulation of small- and medium-sized businesses that can offer drone services locally,” he said.
While donors can and should provide grants in this space, they tend to think one strong use case must mean there are hundreds of others, but from a disciplined investor standpoint, there is no market, Rabley said.
The regulatory environment
Leslie Cary, head of the unmanned aircraft program at the International Civil Aviation Authority, expressed concerns about the ways that donors, United Nations agencies, and others are working directly with governments to develop new regulations.
“We need to get some systematic approach brought to bear on all of this so that we’re not going to end up with a patchwork, which is the direction we’re currently going,” she said.
“To what extent can we help African governments seize the opportunity and define the future they want ... rather than simply become testing grounds for someone else’s pilot projects?”— Edward Anderson, digital development specialist, World Bank
ICAO has established a task force to produce guidance to support humanitarian and development aid activities. But one of the challenges is that not everyone involved, for example the team at UNICEF, has aviation backgrounds, she said.
This December, the Lake Victoria Challenge will gather investors, businesses, regulators, and others in Mwanza City, Tanzania to explore the regulatory, safety, and cultural implications of drone technology.
Edward Anderson, a digital development specialist at the World Bank, that is organizing the event, said part of the goal is to help regulators assess whether drones make sense in their contexts, not just in terms of airspace risks, but also in terms of cost and benefit.
Many civil aviation authorities in low- and middle-income countries copy five-year-old regulations from countries such as South Africa or Australia, which were designed largely to keep drones away from airports.
When the Rwandan government partnered with Zipline, it set an important example of how governments and companies can work together to leverage the power of technology to benefit society.
“There will be some frontier use cases that could be a global proving ground for a global industry, but the ethics of that is to what extent can we help African governments seize the opportunity and define the future they want and use cases they want to see rather than simply become testing grounds for someone else’s pilot projects?” Anderson said.
He said international development organizations can work with regulators to develop their own approaches to using the lower airspace in a way that champions the use cases but is still responsible about the risks.
For example, the World Economic Forum worked with Rwanda to pass performance-based regulations for drones, meaning regulators can specify safety standards drones have to meet, but then take their mission and operations into account.
This could open the door for more operators, including those focused on global health, international development, and humanitarian response objectives, said Timothy Reuter, who leads much of WEF’s work on drones.
Next week, at the inaugural Global Fourth Industrial Revolution Council Summit, experts on emerging technologies including drones will gather at the World Economic Forum’s offices in San Francisco, California, to talk through other key questions — such as what assurances the public needs to feel confident in drones.
Reuter said he expects to see more heavy lift drone delivery, which he thinks could be transformative for global health, but it also makes conversations on regulations all the more critical.
“As we get to weight classes that feel more akin to traditional aviation, you need to put even more thought into what the regulatory framework is,” he said. “It creates new opportunities but also presents new challenges.”
Update, May 28, 2019: This story has been updated to clarify details of the Chemonics project in Malawi.