Launching drone (UAS) deliveries for health operations: Five learnings from real-world projects

In recent years, Outsight International’s Drone Team has worked with development organisations and national civil aviation agencies (CAAs) across Africa and Asia to advance health solutions using drone technology.

Health supply chains in many developing countries face important challenges, like insufficient cold storage and road infrastructure and in rural areas, fragmented management, safety concerns or limited availability of trained staff. Furthermore, each medical product has its own characteristics, making it difficult to find a solution that works for all items. For example, vaccines require a reliable cold-chain, and have a fairly predictable demand, while blood or anti-venoms have a much harder to predict demand as sudden peaks of demand may occur in any particular location.

Drones – also referred to as uncrewed aerial systems or UAS – can help address some of these supply challenges by quickly reaching remote locations from well-equipped warehouse facilities. There are many experiences of these uses across the world; drones have been used to deliver emergency medical supplies or tests in Malawi, vaccines have been delivered in Vanuatu, and extensive drone delivery networks for blood and other health products on a regular basis have been operating in Rwanda and Ghana for a few years. However, drones are not a magical solution for all health supply issues in any location. In this post, we share five key learnings emerging from our practice:

1. Understand the challenges of the health supply chain

Prior to developing a drone medical delivery system, it is important to understand what works well and what can improve in the existing supply chain of health items. Drones may be suitable to cover some gaps, but not all. A comprehensive supply chain assessment with a systems-thinking lens will avoid common pitfalls derived from a lack of understanding of the ecosystem in which medical transportation happens.

2. Assess the feasibility of drone deliveries

Even if some identified gaps of the health supply could improve by using drones, they may still not be a feasible solution. Drone suitability also depends on many non-health related factors, such as the drone parts supply chain, technical feasibility, maintenance, workforce available, or community engagement. One of the hardest issues to assess in advance are costs and cost-effectiveness of drone operations with respect to alternative means of transportation.

3. Regulation is a key enabler of drone operations

The regulatory environment is an essential factor to analyze when launching any drone program. However, as health deliveries involve relevant risks and operational complexities, regulatory requirements are more strict than other drone use cases.

In recent years many countries have approved regulations that include provisions on how drones can be operated, what authorizations are needed, what uses are forbidden or what are the requirements to prevent harmful uses. For health operations, some relevant rules to consider typically include limitations on cargo drops, weight limits, operations beyond visual line of sight or transportation of dangerous goods.

On the other hand, some countries do not yet have drone regulations in place. In these cases, some governments have allowed certain ad-hoc drone operations, but the lack of legal certainty is an important barrier for the development of the civil drone ecosystem. As the international drone regulatory ecosystem has been maturing, countries that plan to adopt drone regulations may benefit from comparative expertise including International Civil Aviation Organization model regulations, best practices from other countries in their region, or technical assistance from drone policy experts.

4. Procedures and supporting materials are essential to put legislation into practice

Drone regulations are a basic enabler for health operations, but not enough. National civil aviation agencies need complementary procedures that link abstract regulations with day-to-day practices in order to run drone operations safely, securely, and efficiently. Relevant procedures include drone operator registration, drone registration, type certificate acceptance, airworthiness verification or operations manuals.

5. Capacity building facilitates implementation

Capacity building and training of personnel involved in drone projects is essential for a successful implementation of healthcare drone operations. Limited capacity is a common challenge that often introduces significant delays and higher risks in operations.

To support local capacity, ICAO and drone experts provide technical assistance to civil aviation agencies at the country level. Additionally, initiatives like UNICEF’s African Drone and Data Academy also contribute to the development of local capacity to build, use and maintain drone technology.

The drone team at Outsight International supports NGOs, businesses and governments on their journey to leverage drones. We offer omni comprehensive services from piloting a small scale UAS program to developing a national drone policy, including market research, cargo and supply chain integration, or our own methodology 360 feasibility studies.

Bonus tip: As with any innovations, is it important to incorporate monitoring, evaluation and learning (MEL) to programming. Emerging technologies and pilot projects often have limited data on their impact so a solid MEL system can provide evidence for decision making and support a case to scale, allowing organisations to maximise their impact, accountability and learning.

ABOUT THE AUTHORS

Denise Soesilo
Denise is an expert in unmanned aerial system (UAS) use in humanitarian and development settings. She has worked with donor agencies and development organizations, humanitarian and United Nations organisations, advising on the application and implementation of drone technologies. Denise served as the director of flight in the African Drone Forum - Lake Kivu Flying Competitions and implemented numerous other drone operations. Through her work, Denise has enabled the safe operations of nearly a dozen cargo drone companies. In addition, Denise has led the implementation of the European Union Humanitarian Aid innovation grant on drones in humanitarian action. Denise has authored several publications on UAS in development and humanitarian action.

Pablo Busto Caviedes
Pablo specialises in monitoring and evaluation (M&E), policy research, qualitative and quantitative data analysis. His experience includes a diverse range of social and economic development topics such as rural development, agriculture, or social inclusion. He currently primarily works as an Impact Analyst for evaluation studies at another non-profit organisation.

Addressing drone noise pollution: a public engagement perspective from the front lines

By Denise Soesilo and Bo Jia

We began our journey in 2015 helping organisations and health actors plan out and implement medical drone operations in rural settings. However, as technology has advanced, we see more exciting projects that bring drone deliveries into urban areas. One example is the planned Rigi Tech operations across Lake Geneva in Switzerland, proposing daily deliveries of medical samples between doctors offices in Rive Gauche and Coppet across the lake. The hope is to cut health care system costs, reduce emissions and remove cars off the streets, which everyone agrees is great. But this also brings drones closer to where people live and work every day and raises questions with regard to new types of noise pollution. 

Urban Air Mobility (UAM) is defined by EASA as an air transportation system in and around urban environments providing connectivity within the cities and among regions. In recent years, Europe has been perceived as a market leader in the development of UAM. According to EASA, the European UAM market size is predicted to be 4.2 billion EUR by 2030 (see the report we wrote together with the European Institute of Innovation and Technology for more details). 

According to an EASA study on social acceptance of drones, noise is the second main concern after safety. The study concluded that people often find drone noise more annoying than other city sounds. To develop sustainable UAM in Europe, it’s thus critical to address the noise-related concerns expressed by EU citizens. We found that technical and policy guidance is slowly emerging but many unknowns still need to be solved. 

From a technical perspective, there are ways to make a drone quieter, such as using noise-reducing propellers and noise-reduction shrouds. The industry is working full steam on these approaches and whilst critical, there are also important social elements that need to be addressed. In the following we discuss what we have learned about how to effectively address people’s concerns through public engagement. 

The core of this approach is twofold. When engaging with communities we have learned that transparency and early engagement are key. In addition, technical elements and available information needs to be compiled and shared in a way that helps communities engage in a meaningful way. This also signals that industry players are applying best practices to address any potential issues. 

The first step is to ground discussions on facts and data as much as possible and to provide transparency. This means actual drone noise data needs to be collected and modeled or measured in situ. This data will be crucial to inform the affected neighbourhood as well as report to local authorities. This data will be complemented with ancillary information such as prevailing regulations and noise pollution benchmarks. The second step is to enagage the community and understand their perception and fears. Often the history of the community plays a strong role in beliefs and perceptions about noise and industrial projects. If a community has previously had poor experience with environmental nuisance, then this will likely also come to the fore during these discussions. 

Measurement of Drone Noise 

The measurement aspects are an evolving topic, and there are still gaps in academia and practice. Although different projects and research teams have tried to measure the noise, there is currently little industry standard or binding regulation in this domain.

In a real-life measurement, the steps of different approaches include noise metrics selection, test environment conditions, drone spatial positioning, microphone characteristics, and mathematical modelling. It is a technical activity that requires specialised equipment and scientific methodology. Currently, the most relevant guideline is the EASA draft guideline published in 2022 on noise level measurements for drones below 600kg. This guideline is intended to be used on a voluntary basis and does not constitute applicable requirements for the certification of drones, but it also points to the direction for potential future regulation in Europe. It provides noise measurement standards in the specific category that includes activities such as package deliveries, powerline inspections, wildlife control, mapping services, aerial surveillance or roof inspections. The guideline detailed the entire procedure of noise measurement, including test environments, spatial positioning, speed measurement, test equipment, microphone setup, and gives detailed technical requirements for each step. 

Another way to obtain noise models is through noise simulation, which requires less hardware and testing. A team from Hong Kong has measured the noise impact of delivery drones in an urban community based on a flight simulation and noise assessment platform, which contains the flight dynamics, noise source prediction and long-distance propagation modules. The EU-funded project AURORA is in the process of validating a noise pollution model. The APIS project from Stockholm also aims to establish a user-friendly platform which allows for the simulation of noise from drones. 

As mentioned above, many studies have pointed out that drone noise is perceived as substantially more annoying than road traffic or aircraft noise due to special acoustic characteristics. The noise of drones does not resemble the noise of contemporary aircraft which leads to an important uncertainty in the prediction of the perception of drone noise. Different metrics such as Tonality and Loudness-Sharpness interaction might need to be measured to be able to account for the perceptual features of drone noise.

Recommendations

After obtaining noise data and understanding people’s perceptions, what can we do to address concerns? The key is when and how to engage affected communities. First of all, it’s always better to start outreach as early as possible. It can be in the form of a community meeting or roadshow that invites affected people. For the drone project team, it’s suggested to designate a person or even a dedicated unit, depending on the size of the project, to be in charge of community affairs and sensitization. This team should be introduced in brochures or on the website of the project with a detailed description of what they do. A fixed and familiar face can help win trust from the affected people. 

As for the content of the communication, the accurate measurement of the drone noise should be shown to the audience. This can be a noise mapping in the neighbourhood or a printed noise report that can be handed out to the participants to form a basis of discussion along with the efforts the project is already taking to address concerns.

Besides the noise data, it’s always helpful to communicate the purpose of the drone operation. incliding any added value to the neighbourhood as well as to society that will be derived from the operation. People will more likely accept an inconvenience if it is for a positive societal cause such as the delivery of medical supplies or reducing traffic and pollution.

About the authors

Bo Jia
Bo has supported several digital agriculture projects, covering topics such as M&E, digital finance, e-commerce, drones, etc. His research helped push for more programmatic and strategic approaches to analyse digital products and investments in the organisation. He is also experienced in ecosystem mapping to identify potential investment opportunities and improve resource mobilisation.

Denise Soesilo
Denise is an expert in unmanned aerial system (UAS) use in humanitarian and development settings. She has worked with donor agencies and development organizations, humanitarian and United Nations organisations, advising on the application and implementation of drone technologies. Denise served as the director of flight in the African Drone Forum - Lake Kivu Flying Competitions and implemented numerous other drone operations. Through her work, Denise has enabled the safe operations of nearly a dozen cargo drone companies. In addition, Denise has led the implementation of the European Union Humanitarian Aid innovation grant on drones in humanitarian action. Denise has authored several publications on UAS in development and humanitarian action.

Implementing cargo drones in Africa: Some lessons from the field

Denise (in the yellow vest) with the pilots during the Lake Kivu Challenge in February 2020.

My experience working in the cargo drone field

My journey with drones began in 2015, working with FSD on a dream project funded by the European Union Humanitarian Aid. The objective was to find out how we can use drones for anything anywhere in humanitarian settings. Given a blank slate and the task to find the most effective and promising applications, there was no better way to find out than to try.

Within the two years we implemented mapping projects in the Tadjik Pamir Mountains, Switzerland and Malawi, and deployed drones as part of an emergency simulation in France. During those years I also began first discussions with large medical humanitarian organisations to develop pilot implementation for cargo drone transport of diagnostic samples in hard-to-reach places. After having spoken to many tech providers, carefully weighing the pros and cons we decided that at that stage in 2016, the technology was still too early in its development to responsibly take into a real-world setting.

In 2017, I began a deep dive into cargo drone operations, working on the Lake Victoria Challenge in Tanzania, which was followed by the African Drone Forum Lake Kivu Challenge in Rwanda in early 2020. During those years, I worked closely with nine cargo drone companies to enable their flying operations. Seeing the industry evolve over the years, I am confident that we are ready to take this to the field in 2020 and 2021.

Where are we now?

Zipline is the only company so far that has been able to provide cargo drone services at scale – operating on the continent with some impressive successes to date. The initial business model is based on delivering transfusion blood. Today, four years after Zipline’s first delivery flight in Rwanda, the nation is on track to shift its entire transfusion blood supply to drone logistics reaching every part of the country in less than an hour upon receipt of the order. 

Medical deliveries and other development objectives remain at the core of the drive towards enabling a thriving drone industry in Africa, and the recent African Drone Forum has confirmed the appetite and commitment towards these objectives. Following the success of Zipline, the industry has been busy rising to the challenge.

The global drone logistics and transportation market is forecast to reach 11.2 billion USD globally by 2022, yet only a fraction of this market growth is forecast to take place in Africa. This is due to a combination of factors, but particularly that implementing high-tech solutions in remote settings has many risks and challenges. And there is not much experience or guidance out there in how to navigate these.

The following are some key lessons I’ve learnt over the past five years working in the sector, coordinating between industry, donors and governments.

What to look for in a cargo drone delivery company

Four key considerations I advise clients to consider seriously before working with any technology are the following:

• A demonstrated commitment to safety. This cannot be over-emphasised and should be one of the first considerations. Technical documentation, operations manuals, flight and maintenance reports are crucial to build a track record. To be absolutely sure, it can be beneficial to solicit the advice of one or several subject matters experts. This procurement guide provides a helpful checklist of documentation to request when looking to hire a cargo drone company.

• Technical specifications and business model appropriateness. Do the technology specs and business model align with what is required for the use case being addressed? Is the company committed to building technology for cargo delivery? Can the application accommodate African business models? I still encounter companies that have a primary focus in data collection (mapping and monitoring) but say they can easily also deliver cargo. That is a red flag for me. There are significant (technical) differences implementing these two applications and cargo drone work deserves full attention to its specific challenges.

• Range. Bigger is not always better but when flying drones in the expanses of the African continent, range can make the difference. Studies recently published in the Lancet show that drone logistics work in the African context can only compete with alternatives — namely motorcycles and other ground vehicles — in terms of cost effectiveness starting from a minimum range of 60-65 km both in routine and emergency scenarios. All the companies on our list can cover at least this minimum range. Many pure copter designs have a range limit of 20km and are not suitable for typical African use cases beyond urban deliveries. 

• Willingness and ability to adapt. When implementing projects, delays and setbacks are to be expected. We are charting very new territory. Building relationships based on trust and openness will help companies better understand their customers while implementing organisations can get the most out of their investments through valuable lessons-learned. 

Volansi getting ready for take-off.

Who’s doing what?

Here are some of the most promising drone tech providers I have been keeping an eye on — besides Zipline of course: 

• Avy - This Dutch company adheres fiercely to its “drones for good” slogan, keeping to a strict civilian focus. Avy’s Aera aircraft is being prepared to deliver medicines in the Netherlands within a year — circumventing traffic for essential and high priority deliveries. The aircraft is small and light with a payload capacity of around 1 kilogram — just enough for these high-value products. However, like many of their competitors it is likely that a larger model is in the making. Avy is no stranger to the African continent, having provided surveillance support for anti-poaching and park management activities.

• Phoenix Wings - Their Manta Ray aircraft is a heavy lifter among the small electric cargo drones. The aircraft was designed around the cargo and that thinking has paid off beautifully: the Manta Ray SR easily carries 7 kilograms in a 30 litre cargo compartment with a range extending more than 60 kilometers. Its signature turn into the wind upon take off is reminiscent of a spaceship in flight. Upon landing at the delivery location, the cargo compartment is released automatically.

• RigiTech - This Swiss company has an impressive track record within their management. Two of its founders were part of Sensefly’s early start-up team before moving into the cargo drone business. The third co-founder is an MSF veteran having conducted medical delivery operations in Papua New Guinea as early as 2015. RigiTech’s business model centers around developing a complete hardware and software platform for cargo logistics.

• Swoop Aero – This fast-rising Australian start-up has been flying vaccines for UNICEF and is about to start major operations in the DRC. From the outside, the aircraft looks less shiny than some of the competition, but the fundamentals are designed for safety, reliability and durability, which has proven to be a winning strategy. Swoop Aero is committed to expanding healthcare access through their logistics services and they are quickly establishing themselves as a market leader.

• Vayu – Vayu has settled on a long-range design that is capable of several hundred kilometers (up to 800 kilometers to be precise) of flight. Vayu provide the only gasoline-powered aircraft in this list, and have been involved with the development sector projects for years, striving to make solutions that work. In some environments the use of fuel can be justified as it greatly extends range compared to battery powered systems.  

• Volansi – Volansi is another Silicon Valley backed start-up with an impressive line-up, having logged experience in both North America and Africa. The company participated at the African Drone Forum Lake Kivu Challenge — and demonstrated solid tech and a highly professional team. A new aircraft has been in development, and will be launched shortly, so expect to hear a lot more from Volansi in the near future. 

• Wingcopter – Known for their fine German engineering and for having produced the fastest civilian drone (fast = stable flight in the cargo drone world), Wingcopter has made recent headlines with a strategic partnership with UPS. Wingcopter are also veterans when it comes to operating in Africa and other rural settings, among others delivering vaccines with UNICEF in Vanuatu and delivering health supplies in Tanzania. Wingcopter have adapted quickly to their customers’ needs by developing the winch system that lowers their cargo without the need of landing the drone.

A Wingcopter aircraft winching down a cargo box.

Implementing cargo drones in development

Implementing the use of cargo drones for logistics is a complex matter that requires careful choreographing. Safety (and security) management will take much attention and time. This includes: risk assessments; implementing risk mitigations; route planning; applying for activity permits and potential certification; air traffic management; and coordination. In addition, other aspects need to be managed: procurement; use case analysis; perceptions; waste and other environmental concerns; insurance; import and export; operations; skills development; regulations; perceptions; (data) protection; cost-benefit analyses; and media — among others. Since in many environments the cost-benefit is not yet fully established, future implementations should also be designed around collecting quality data. Cost-benefit analyses will require data on major cost drivers of drone operations such as failure rates under various operational conditions, down-time due to weather conditions and fixed costs for maintenance and running the operation.

To pull so many aspects together, whilst also dealing with multiple stakeholders with different interests, requires significant expertise, diplomacy and technical knowledge. Although, complex, I have seen that it is possible to bring all the pieces together efficiently and effectively. Any new implementations must build on the — so far — established best practices and lessens learned. This will help elevate cargo drones to their full potential in Africa.

ABOUT denise soesilo AND OUTSIGHT INTERNATIONAL

Denise is one of the Co-founders of Outsight. She is a world-renowned expert in unmanned aerial system (UAS) use in humanitarian and development settings, and in operationalising clean technologies. She has worked with the World Bank and other development, humanitarian and UN agencies — advising on the application and implementation of space-based systems and UAS technologies in humanitarian operations. Denise was directing the flying operations of the African Drone Forum. Denise has led the European Union Humanitarian Aid innovation grant for the implementation of drones in humanitarian action globally and has authored several leading publications on UAS in development and humanitarian action.

Outsight International provides services to the humanitarian and development sector in an efficient and agile way. Outsight International builds on the range of expertise offered by a network of Associates in order to deliver quality results adapted to the specific tasks at hand. If you’d like to discuss working with Denise and the Outsight team, please get in touch or follow us on LinkedIn for regular updates.