Zipline’s just-in-time drone-delivery technology has helped transform Rwanda’s medical supply chain. (Photograph courtesy of Zipline) 

Delivery by drone is not a novelty for Silicon Valley-based startup Zipline—it’s a matter of life and death in the regions that the drone-delivery system serves. In October 2016, the company launched an on-demand service in contract with the government of Rwanda to deliver more than 50 different types of blood products (blood, plasma, and platelets) for immediate medical treatment.

Rwanda was an ideal first partnership country for Zipline: It has one of the highest population densities in sub-Saharan Africa, and 70 percent of the population lives in rural areas. Zipline operates two distribution centers carrying three days’ worth of supplies, which together distribute drones to all 10,169 square miles of the landlocked country.

While Zipline markets itself to governing bodies as a logistics service, the company does not contract with other drone manufacturers—it makes its own. “There was no technology like this when we started,” CEO and founder Keller Rinaudo says. On opposing ends of the price and functionality spectrum, there were $60 million military-operated devices and $100 plastic helicopter toys—both of which were drones. Zipline designed a drone that can handle flights of more than 100 kilometers over autonomous areas and can be easily maintained. It does not plan to sell its self-proclaimed “automotive grade” drones. “Our customers don’t care about drones at all,” Rinaudo says. “[They] want to focus on taking care of their patients.”

Zipline dispatches a drone with a package to the healthcare practitioner who ordered it via SMS or WhatsApp. Delivery takes 15 to 25 minutes. Rinaudo claims that the boxes don’t need a cold chamber because the deliveries arrive before the products lose integrity. But more scientific studies must be done before drone delivery can be claimed to be entirely safe for medical supplies, says Bruce Y. Lee, associate professor of international health at the Johns Hopkins Bloomberg School of Public Health. “The situation is that heat can denature proteins in vaccines or other biological products like blood,” he explains. “It can change the nature of the product. Most likely it’s not a concern, but we need more studies.”

Despite his caution, Lee supports using drones in the supply chain because they can reduce costs up to 50 percent compared with land-based transportation, which requires human personnel. Furthermore, a drone-based delivery system could lessen the workload for medical practitioners, who, in many rural areas, simultaneously serve as doctors, transporters, and suppliers.

Integrating with the local community is an essential concern to Zipline. Currently 30 of its 100 employees are Rwandan. “There aren’t many other opportunities to become an expert in robots there,” Rinaudo says. “In parts of the world, drones have a negative connotation, associated with military,” Lee adds. “We can’t underestimate the fact that people fear when they see drones.” Rinaudo acknowledges this association, but credits the support of the local government for the positive reception of Zipline’s integration by Rwandans into the national health-care system. Before Zipline contracted with the Rwandan government, lack of infrastructure contributed to excess waste of blood products—a common supply-chain issue in many other countries.

Though Zipline is the most established example right now, other companies are manufacturing drones specifically for humanitarian purposes. This year, Netherlands-based Wings For Aid is testing its own remotely piloted aircraft in the Dominican Republic. “Tech that is available to military forces should also be available to the humanitarian world,” founder and general manager Barry Koperberg says. “A lot of innovation comes from public forces. The Internet, mobile telephones—all invented by the military.”

Organizations like Wings For Aid look to Zipline as an excellent initiative for small-cargo payloads. (Wings For Aid’s drone is larger and meant for carrying 20-kilogram boxes full of disaster relief supplies, such as blankets and water.) And Zipline has the results to show for its efforts in streamlining the medical treatment supply chain: In Rwanda, access to rare products has increased by 168 percent and blood waste has decreased to zero. Hospitals no longer have to keep in stock what they don’t need. Since the program’s inception, the company has delivered 12,000 units of blood on more than 6,000 flights in Rwanda. By the end of 2018, Zipline will operate in rural North Carolina—its first North American contract.