Using the Unmanned Aerial Vehicle Delivery Decision Tool to Consider Transporting Medical Supplies via Drone

Unmanned aerial vehicles (UAVs) or drones are increasingly explored as a solution to transport challenges for medical goods, including emergency blood supplies, vaccines, medicines, diagnostic samples, and even organs, particularly for “last mile” delivery.1,2 Proof-of-concept tests have demonstrated the technological viability of UAVs to safely transport medical supplies3–6 and keep them within the required parameters for clinical viability.7–9 A few research studies have determined the cost-effectiveness of adding UAVs to specific medical supply chains1,10 or the optimal placement for UAV stations.11–13 Yet very few cases of successful scale-up of UAVs for medical transport exist. Recent work has focused on proving a UAV can successfully complete a flight but has neglected to address health-system integration and long-term sustainability. As a result, decision makers lack information on how to explore the potential utility of UAVs in addressing medical transport challenges and, if determined useful, how to add UAVs to health systems or achieve use at scale. Successful implementation of any health system change relies on a complex set of factors.14 In the case of UAVs, not only will the selected technology need to be appropriate for the distance, weight, and size requirements of the transported items, but (1) it will need to operate within regulations, (2) the concept must be embraced by stakeholders, (3) financial resources need to be available, (4) human resources must be in place, and (5) operational procedures must be developed to effectively work within existing structures. When these aspects are not considered, operations can be delayed, inefficient, or fail entirely. In short, as with any intervention, the impact of UAVs on the broader health system should be considered before implementation.15 Using the framework of the World Health Organization health system building blocks,16 this commentary describes challenges for integrating UAVs into complex health systems and presents a tool for considering whether UAVs could help address medical transport challenges and how they can be integrated into health systems. Under the assumption that readers may be unfamiliar with UAVs, we begin with some general information (Box). BOX What Is an Unmanned Aerial Vehicle (UAV)?1,4