Capturing maximum value from drone delivery for medicines requires a combined effort from technologists, government leaders and healthcare and social advocates

Dr Suresh Munuswamy, Head - Technology Innovations and Health Informatics, Public Health Foundation of India (PHFI), in an interaction with Kalyani Sharma, talks about the recently adopted 'Medicines from the sky' initiative by Telangana government and highlights its various aspects

Walk us through ‘Medicine from the sky’ (MFTS) initiative.

MFTS is a joint World Economic Forum, Public Health Foundation of India and NITI Aayog initiative created to develop field reality supported ecosystem and assist policymakers, health systems professionals in analysing the opportunities and challenges of drone delivery as well as understand competing delivery models and technologies.

Capturing maximum value from drone delivery for medicines requires a combined effort from technologists, government leaders and healthcare and social advocates to ensure systems are designed in a way that addresses ground need, protects public safety, ensures diverse community interests are represented. MFTS also considers how the integration of new technologies into healthcare supply chains can be done in a cost-effective manner that does not drain investment capital from other parts of the system and facilitate Universal Health Care.

Tell us about the key aspects of this technology.

Traditionally, the approach of handling last and middle mile emergencies has been focussed around the response to events and stimulus on occurrence. Addressing residual risks through warning systems and developing emergency response plans have been the fulcrum in managing disasters.

Owing to the vast range of hazards and the limited possibility of predictions, disaster situations in India are inherently compounded by lack of information and spot availability of data and resources. A single, overarching solution may be prohibitively extensive. However, a well-designed based-on-drone platform can create pathways that catalyse our response and could potentially be economically viable and sustainable.

MFTS focus is on heavy payload, long-range drone paired to a custom-developed modular temperature-controlled box platform that can safely and reliably deliver multiple medical payloads simultaneously and improve access to vaccines, lab samples and possibly on-demand medical products to primary health centres and subcentres in rural, remote and hard-to reach areas.

What were the major challenges faced at various stages of this project? Are there any gaps that still need to be filled in the overall implementation of this technology/initiative in India?

PHFI’s Hi Rapid Lab has been working on drones for healthcare since 2015. During the initial stage, regulations were quite prohibitive. The COVID-19 pandemic showed us several-use cases of drones and also the need for home-based or near point of need healthcare service. In a country as vast as India, drones presented an unmatched model of effective reach which can address our existing middle- and last-mile medical logistics issues. The government of India released new supporting drone policy relaxing several previously restrictive regulations. It is now the role of industries and-up companies to advance the drone ecosystem. India needs to explore building several categories of drones of varied ranges and payloads. Several specific modifications designed for applications need to be researched on. For instance, healthcare requires temperature-controlled boxes, that also need to be light weight, durable, able to maintain fragile medical vials, safe and vibration-free during drone transport over long distances. PHFI’s Hi Rapid Lab is working on such a solution. However, sourcing IoT is a challenge, because of global chip shortages and stresses supply chain lines.

The government of India recently announced Production Linked Incentive (PLI) scheme which is welcome to start ‘Made in India’ drones. On the same lines, it would also help to provide grant in aid for startups and R&D institutions for India-specific innovations.

Telangana has already adopted this initiative. When can we expect the nation-wide adoption of this technology?
Almost all north-eastern states, along with Gujarat and Odisha, have expressed interest to start year-long regular drone-based medical delivery service to several hard-to-reach primary health centres. We soon expect almost every state in India to adopt drones for medical deliveries as almost every state has health facilities that are in forest areas or beyond rivers in valleys. An ambulance and fire service type service and financial operational models are being proposed as drones can lead to substantial saving of lives.

Can you share some insights on the financing models that are being discussed to operationalise it beyond government use?

After test flights in Vikarabad with heavy payload long-range drones, several use cases have emerged in our discussion threads including logistics applications for high-value horticulture, aquaculture, food products, geographical-indexed products that are produced in hard-to-reach, remote areas, and are currently facing challenges reaching all – whether road heads are connected to national air or rail network. Most of these products also require temperature control similar to, but not as rigorous as medical applications.

A drone that can carry 50-100 kgs with temperature control and fly for 100-200 kms seems to have several use cases and a viable business model. In our opinion, the last-mile transportation in hard-to-reach areas is currently almost five-to-10 times more expensive and still very unreliable than regular last-mile transportation in plain well-connected areas. This current mark-up provides for an immediate business case when compared with drones. Several use cases served simultaneously will help medical logistics by rationalising service costs over a wider denominator and provide for redundancies.

Can you throw some light on the role of partnerships and the PPP model in the successful implementation of this initiative?

Partnerships need to happen at several levels. At the current exploratory research and development level, partnerships need to happen between CSR foundations and R&D centres. As the next step, partnerships are being developed between state government health systems, startup companies and larger industries. WEF, PHFI and NITI have created the industry core group to facilitate regular discussions. Industry representatives from Reliance, Tata, Adani, MapmyIndia, Godrej and Novartis have participated in these discussions. Large-scale year-long pilot projects for regular service medical drones are being currently planned for atleast half-a-dozen states. With this evidence, several service models will be explored. The present front-runner model is the 108 PPP ambulance service.

Can you share your views on acceptance of this technology in India?

India is a country of 1.3 billion people with diversities that are not seen in other countries, and that applies to technologies. People are on either side of the spectrum-supportive and skeptical. There are some who believe that drones are the only means of delivering universal healthcare in India and there are others who believe drones delivering medicines to the remotest corner of India is just wishful thinking. One area that everyone agrees on is the clear need and the potential of drones in addressing them. Our approach lies in data-based research-led optimistic and collective thought process…the “medicine from the sky” project. We are bringing more people on board with our evidence-led reasoning approach and it is working successfully.

Dr Suresh Munuswamydrone delivery for medicinesMedicine from the sky' initiativeMFTS initiativePHFIPPP modelPublic Health Foundation of India
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