Cutting-edge treatments have transformed HIV from an all-but-certain terminal illness into a chronic but manageable condition in developed nations like the United States. And yet an estimated 10 million people around the world are unable to get the medications they need. Case in point: the residents of Uganda’s Kalangala District.
One look at a map and it’s easy to see why ferrying HIV medications might be a slow and time-consuming process. The region is made up of 84 islands in Lake Victoria; getting to the remote area in East Africa is possible only by boat. There are 1.4 million people in Uganda living with HIV, and while rates of infection on Uganda’s mainland have declined over the years, rates on the islands have increased by up to 25% annually, due in part to political and cultural barriers to HIV prevention programs there.
As part of Johnson & Johnson’s commitment to advancing equitable access to medicines, the company is supporting an innovative program that uses medical drones—essentially small 22-pound unmanned aircrafts—to deliver HIV treatments. Specifically, the drones are delivering antiretroviral therapies provided by the Ugandan Ministry of Health to the people of the Kalangala islands.
The first of these regularly scheduled drone flights took place in April. But before the Kalangala District Medical Drones Project officially launched, Johnson & Johnson and its partners held a demonstration using a “showcase drone” to familiarize villagers with the concept of drone deliveries. “The response was amazing,” says Dr. Rosalind Parkes-Ratanshi, Director of the Academy for Health Innovation in Uganda. “When the drone started to lift off, the villagers moved back in fear of the movement and the noise. But then, as it took off, everyone clapped. More and more people then turned up and were very excited as it came back down to land.”
As the International AIDS Conference kicks off, we take a behind-the-scenes look at how medical drones will work to improve treatment access in one remote corner of the world—and, hopefully, in many more global corners to come.
1.
Navigating a challenging location
The Kalangala islands are widely scattered in Lake Victoria, the world’s largest tropical lake.
“Due to the large water mass, access to medicines and treatments is a huge challenge because you have to travel to and between the islands by boat,” explains Robert Kimbui, Senior Supply Chain Manager, Africa operations, Johnson & Johnson. These journeys are expensive, unreliable and fraught with dangerously unpredictable weather and strong currents.
2.
A historic lack of healthcare access
“In Africa, primary healthcare facilities tend to be very remote,” says Kimbui, and that’s particularly true in the Kalangala District. Case in point: Of the 84 islands the district comprises, only about half are inhabited and just seven have healthcare facilities.
Beyond the great distances health workers have to travel between those facilities to see patients, the COVID-19 pandemic has put an acute strain on Ugandan healthcare systems, as it has in many countries, further disrupting continuity of care for existing conditions like HIV.
3.
High-tech troubleshooting
Drones offer significant advantages over boats: They can make multiple trips in a single day, serving 20 landing sites across five islands and reaching more than 3,700 inhabitants, roughly one-third of whom are living with HIV/AIDS. Because the drone deliveries help ensure that each landing site is effectively stocked with medication, islanders are better able to get what they need at a health center that’s most convenient for them.
While the pilot drone shown here can carry up to 2 pounds of medication, the medical drones currently delivering treatment to the Kalangala District have the capacity to carry five times as much.
4.
A sustainable solution
While using drones to deliver medication is not new, the Kalangala District Medical Drones Project stands out, as it has been designed to be sustainable with support from the community, local partners and the Ministry of Health. This means that villagers will be hired and trained to provide technical support for regular, ongoing drone deliveries and healthcare workers will be trained to administer the medicines. (Above, a local healthcare worker is shown removing HIV medications from the showcase drone.)
The initiative also aims to reduce the burden placed on frontline health workers: With the drones delivering HIV drugs directly to local staff, regional healthcare workers will no longer need to journey around the islands delivering medication, saving them time they can use to perform essential services such as routine healthcare and COVID-19 testing and treatment.
5.
Extending healthcare beyond the clinic
Once healthcare workers have removed the HIV medications inside the drones, they send these flying couriers back to their starting point, carrying lab and blood samples from villagers who’ve received treatment to allow for regular testing of their viral loads. “From the main island, the viral load samples travel to Masaka Regional Referral Hospital, then to Kampala to the main public health laboratory, which can take several days if drones are not involved,” says Dr. Parkes-Ratanshi.
6.
The future of drug delivery
The Kalangala District Medical Drones Project runs through April 2022, when Johnson & Johnson and its partners will conclude the year-long study into the benefits of the technology for HIV patients living on the island and how it can be scaled to solve other healthcare access challenges.
In the near future, for instance, drones could be used to deliver essential health supplies and respond quickly in the event of an emergency or disaster. “We can use the drones for anything, including vaccines or any other kind of healthcare product,” notes Kimbui. This pilot project “is a unique showcase of how we can use smart supply chain technology to tackle geographical boundaries. It is very impressive and exciting.”
