Judith Sherman saw the potential of drones to improve medical services in Malawi. Image:JS/UNICEF

Interview: Judith Sherman of UNICEF

Interviews

Over the past four years, Judith Sherman of the United Nations Children’s Fund (UNICEF), HIV/AIDS coordinator for Malawi, has worked with partners to find drone solutions to medical logistics problems in that country. The result is a vibrant c-drone ecosystem, Beyond Visual Line Of Sight (BVLOS) flights over Africa’s first drone air corridor, legislation passed regulating the safe use of drones, and of course many lives saved. The C-Drone Review met with her following her presentation at the InterDrone show in Las Vegas.

Q: Here at InterDrone with Judith Sherman of UNICEF. I would like to ask you, first of all, how serious is the AIDS problem in Malawi?

Judith Sherman: HIV has been on the decline in Malawi, so from a high of 14% in the late 1990s to the current 8.8%, but that still makes it one of the highest epidemics in the world. So although it has declined it’s still a serious problem. And that percentage is among adults. Among children 0-14 years old it’s 1.8%, so nearly 2% of all children in Malawi are living with HIV. So, yes, it’s still a very serious problem that UNICEF and the government are addressing along with many other partners.

Q: What are typically the difficulties in AIDS/HIV treatment in Malawi?

Judith Sherman: One of the issues that we’ve been focusing on particularly for children is ensuring that children are diagnosed early and put on treatment as soon as possible. Treatment saves lives. But if you don’t know your HIV diagnosis and you’re not on treatment then you’re going to face an earlier mortality. So early infant diagnosis has been a top priority for us.

Q: You’ve been using drones to solve the transport problems, the turnaround time for sending blood tests to the labs. Perhaps you could tell me a little bit where the idea came from and what the timeline has been in your project?

Judith Sherman: The idea really came from reading an article in an inflight magazine in 2014 about the delivery of pizza and packages by drones and from that I began talking with drone enthusiasts and hobbyists as well as people in the field of laboratory diagnostics to see whether it would be feasible to carry dried blood spots, the samples that are used for early infant diagnosis of HIV, on drones, to complement the motorbike transportation that’s currently in place.

Q: As I understand, there was one company that was initially involved, Matternet, and then afterwards there were different companies, universities, and NGOs, is that right?

Judith Sherman: Yes. So, for the feasibility study we did a competitive tender and Matternet won the contract for that, so they were our partner and we did a cost analysis with Village Reach. From there, we’ve expanded our work in drones and have been working with a number of organizations, companies, academic institutions, it’s really a very long list of partners over the past three years.

Q: As I understand it, drone flights have been expanded after the initial blood test transport project to assist after floods and even, I saw on the UNICEF Malawi YouTube channel, a recent cholera outbreak?

Judith Sherman: Yes. So from that feasibility study on what has been most important is that we’ve received such support from the government and an understanding of the multiple uses of drones. So from the initial exploration of cargo drones for laboratory samples, we’ve used drones to map areas affected by floods, to survey flood-prone areas, to provide information to the government so that they can better plan for disasters. We’ve used them to examine infrastructure issues, and as you mentioned a cholera response. We did a massive mapping of Lilongwe which is the capital of Malawi to identify hotspots of cholera, drones mapped areas to identify latrines and open wells, and then we superimposed that on good old epidemiology, tracking cases, to create these maps of areas where we could see where the concentration of cholera cases were coming from, and where colleagues working on modern sanitation needed to focus their efforts as well.

Q: Maybe you could talk about the size of the project, how many flights, how many people are involved?

Judith Sherman: That’s a tough question, because there are so many different aspects of the project. So I couldn’t address the number of flights, but we’re working with several different companies in those different areas. For example, currently we’re doing crop surveillance along with other UN agencies, WFP [World Food Programme] and FAO [Food and Agriculture Organization], we have our air corridor where we’re working with a number of companies that are testing both the technology and the use cases and we’re working with a number of academic institutions, again to explore various use cases such as identifying mosquito breeding areas as part of malaria control. And the list goes on.

Q: I understood that the blood samples were actually dried on paper so a fairly large number could be moved in a single drone flight. Medicines and samples seem to be well suited to drone transport due to their small size.

Judith Sherman: For that, in particular, the dry blood spots are very lightweight; the cards that they are on are only 100 grams. But we’ve more recently conducted a study into districts to look at specifically what products, what samples as well as drugs, vaccines, emergency medicines would be well suited both for transportation by drone and what is needed by the health facilities. So we’ve begun designing the technical specifications for that project and particularly how it can complement the existing system. So it’s not that drones will replace anything that is currently being used, but how it will strengthen the transportation system.

Q: You worked with the local government — when I say government, it seems there were several ministries involved — to arrange the drone corridor, the airspace authorizations?

Judith Sherman: UNICEF was the first organization to use drones in Malawi for any noncommercial purpose. We were the first ones to get flight operation approvals from civil aviation. So we really introduced the concept of using drones for development, for humanitarian purposes. And of course that was a process of meeting with a lot of different government partners, with a lot of different government ministries, and throughout that process — which was over a year — what was most interesting was that all of the concerns raised, all of the questions asked, were all very solid, and everybody was committed to finding a solution, primarily because of the use case, because we were focusing on how do we address the issue around HIV and getting children diagnosed and on treatment and that is such a compelling use case for the government. At the same time I do want to mention that the government of Malawi is committed to innovation so not just in HIV, where they have been leading the global response, but in other fields as well. So we are very fortunate to be working with counterparts in various ministries who continue to be very supportive.

Q: Now, from a purely cost standpoint, perhaps the cost of a drone project is comparable to paying motorbike couriers. Is it justified to use fancy drones instead of motorbikes over the dirt roads?

Judith Sherman: The first study that we conducted, the cost analysis, was really a comparison between motorbikes and drones. And that of course highlighted the benefits of using motorbikes, that can carry more and heavier cargo, and their cost is generally lower, particularly compared to some of the higher-end, custom-made drones. But that was already in 2016. Here we are in 2018 and things have changed rapidly. So we’re finding that not only is the technology becoming more affordable, but our understanding of how to integrate drones into the supply chain network has also changed. We recently did another cost analysis looking at optimizing the use of drones in an integrated transportation network and found that it’s not a question of either/or, but how do we maximize their use, and by doing so bring the cost down. We also weigh that against the health outcomes — what are the benefits that we are going to see, what is the cost of lives saved by introducing this new technology? And in the end, the conclusion is that drones are cost-favorable when integrated into a well-functioning supply chain system and when their use is optimized.

Q: Well, yes, I had understood that the turnaround time using the motorbikes for some of these tests from a rural village to the testing lab and back to the village could be up to month?

Judith Sherman: Yes, currently the motorbikes still collect the samples on a regular basis, but there are delays along the transportation chain as samples are batched, as obstacles are met along the way, particularly during the rainy season. And the median time between transporting from the health facility to actual receipt at the lab can be up to 20 days. There are other delays within the laboratory, then getting the results back to the parents. So we’re looking to introduce drones to shorten the delays in any way we can.

Q: Tell me about developing local expertise in drones, are there efforts in that area?

Judith Sherman: In all of the work that we’re doing currently we make an effort to include students from local universities. So for example in the mapping that we’ve connected for the cholera response, we engage students who are studying to be GIS specialists. And in the work that we’re doing in the Kasungu air corridor we insure that every company, every institution, or organization that’s working in the air corridor also conducts workshops with local students in order to build their expertise. So we’re making efforts along those lines to build interest and enthusiasm and engage with universities. On a more formal basis, we’re currently planning to introduce a drone academy for the region. We’ve set up a standard curriculum so that students can gain expertise in building and operating drone technology and linking with universities in terms of data, GIS experts, doing mapping, etc. so that we cover the whole ecosystem of drones and build that local expertise. As well as opportunities for local entrepreneurship.

Q: What are the next challenges?

Judith Sherman: Well, I just mentioned building an ecosystem and I think that is the challenge, that there is a lot of work going on in Malawi right now in terms of drone operations. And as I mentioned, the government is very favorable, the regulations are about to be made into law and the next step is really how do we work together in order to ensure that the the costs are favorable, that the private sector and the public sector are working together. So for example when drones aren’t being used by the health facilities, could they be used by farmers, for their purposes as well, so do a bit of cost sharing. How do we introduce the other aspects of the ecosystem, such as unmanned traffic management. And bring all of these various pieces together in order to continue to showcase how drones can be used in a very positive way to improve development and ultimately to improve the way that we are working for children.

Q: Judith Sherman, thank you very much for meeting me today.

Judith Sherman: Thank you very much.