ICF: Unmanned aerial vehicles ('drones') for sustainable vaccine research and improving equity in vaccine delivery: a feasibility study in The Gambia

Lead Research Organisation: London School of Hygiene & Tropical Medicine
Department Name: MRC Unit The Gambia at LSHTM

Abstract

In low-income countries in sub-Saharan Africa, conducting internationally competitive health research, and providing high quality healthcare to all, requires numerous motor vehicle journeys. Many of these journeys are of short distance (<30 km) and are undertaken to transport small, light-weight payloads including vaccines, medicines, blood transfusions and research samples (e.g., blood samples from adults and children in clinical trials). However, due to poor road conditions and the need for flexible, robust, long-lived vehicles, most journeys are currently undertaken in diesel- or petrol-powered four-wheel-drives. Vehicles like this are some of the least efficient and most environmentally- and health-damaging modes of transport operating.

Emissions of greenhouse gases from vehicles in Africa are increasing by 7% each year. Climate change is already impacting on food security in Africa as well as changing the spread of diseases like malaria and yellow fever that result from mosquito bites. Leadership to reduce these emissions is therefore important. Vehicles, particularly older vehicles, also produce air pollutants which increase the risk of heart and lung disease, diabetes, and strokes. These are diseases that are already increasing rapidly in Africa so new ways to reverse this trend are needed. Environmental noise (or noise pollution) comes mainly from traffic in urban settings in sub-Saharan Africa and can cause sleep and mood disturbances, difficulties concentrating and heart disease. Slowing down increases in these diseases is important too. Finally, road traffic deaths are going down across much of the world, but are increasing in many parts of Africa. They are currently the most common cause of death in 15 to 29-year-olds in West Africa, with nearly half of these deaths being pedestrians. Reducing vehicle numbers through looking at other modes of transport is also one way which may address this important burden.

This study will establish the feasibility, costs, and environmental impacts of using unmanned aerial vehicles (or 'drones') to replace road vehicles for the transport of research samples and healthcare supplies in The Gambia, West Africa. The drones will be solar changed and thus carbon neutral with respect to power.

We will specifically test drones first, to transport blood samples from participants in vaccine studies to a central laboratory for processing, and second, to transport hepatitis B vaccines to rural health posts allowing newborn babies to receive the vaccines on the first day of life as recommended.

Factors including the length of flights (time and distance), the ability to maintain blood samples and vaccines at stable temperatures, power consumption, costs, and safety as well as the impacts of seasonal factors, such as storms and the harmattan winds from the Saharan, on flights will all be explored. This technical data will be complemented by interviews and group discussions aiming to gain a broader understanding of how drone flights are likely to be perceived in The Gambia and other comparable settings.

The study will be conducted in partnership with the Gambian Ministry of Health and Arda, a company aiming to develop drone technology for the purposes described in Africa. Through these partnerships the future impact of the study on environmentally sustainable research and healthcare are expected to be maximized.

Technical Summary

In low-income countries in sub-Saharan Africa, the conduct of internationally competitive biomedical-field research, and the provision of equitable healthcare, requires numerous motor vehicle journeys. Many of these journeys are of short distance (<30 km) and are undertaken to transport small, light-weight payloads including clinical research samples, vaccines, medicines, and blood transfusions. However, due to poor road conditions and the need for flexible, robust, long-lived vehicles, most journeys are currently undertaken in diesel- or petrol-powered four-wheel-drives; some of the least efficient and most environmentally-, and health-damaging modes of transport operating.

Greenhouse gas emissions from motor vehicle transport in sub-Saharan Africa are increasing by 7% annually due to the, largely unregulated, importation of old commercial and private vehicles to the continent and the lack of emissions standards or mandatory testing. Particulate and gaseous air pollutants are also released disproportionately from old vehicles and are associated with increases in cardiovascular and respiratory diseases, and diabetes. Similarly, noise pollution results predominately from traffic in urban settings in sub-Saharan Africa and is associated with sleep and mood disturbances, cognitive impairment, and cardiovascular disease. Non-communicable diseases such as these are expected to be the leading cause of death in sub-Saharan Africa by 2030 and strategies to reverse these trends are therefore essential.

The study aims to demonstrate the feasibility of using Unmanned Aerial Vehicles (or 'drones') to replace motor vehicles for the transport of time and temperature sensitive clinical samples and supplies in the research and medical sectors in The Gambia.

The study will be carried out in accordance with the guidance for feasibility studies set out in the updated 2021 MRC Framework for Developing and Evaluating Complex Interventions.

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