u anshul Sharma, Kundan madireddy

access, speed and automation

Robust health supply chains will be critical in fulfilling India’s SDG-3 targets

As per the Sustainable Development Report 2021, India ranks 120 out of 165 countries in SDG performance. India’s healthcare progress (SDG-3) is classified in the lowest category – ‘major challenges remain’. Multiple indicators, including maternal mortality, TB incidence, universal health coverage are under the ‘major challenges remain’ category.

Healthcare supply chains form the backbone of the health delivery system. Today’s last-mile healthcare supply chains rely on road-based transportation networks, which are not only slow and inefficient for last-mile deliveries of smaller payloads in rural India, but also ill-equipped to handle emergency shipments of lifesaving products. Road transportation also breaks down during natural disasters and increasingly flood-prone scenarios in India.

Drone-based automated supply chains can play a critical role in addressing these gaps. With the ability to fly 24x7 and in extreme heat, foggy, and moderate rain conditions in hills, forests, deserts, and any other terrain, aerial logistics systems can make India’s last-mile health supply chains future-proof, sustainable and scalable.

Medicines from the sky: In September 2021, Telangana became the first state to pilot large-scale healthcare drone deliveries under the Medicines From The Sky (MFTS) programme. This is on the back of liberalised drone regulations in India. In MFTS, over eight drone consortia conducted 350+ flights in 45+ days, varying from 3-42 km distances. This project is a partnership with the Government of Telangana, World Economic Forum, Apollo Hospitals Group, Ministry of Civil Aviation, and NITI Aayog. It is Asia’s largest such project on organised drone trials for healthcare deliveries.

Subsequently, estimates suggest that over 1,000 healthcare Beyond Visual Line of Sight (BVLOS) flights were conducted in more than 10 states. Covid and routine immunisation vaccines, essential and emergency medical products, consumables like syringes and gloves were shipped using drones.

These programmes have demonstrated significant impact. Drones cut down travel times manifold. For example, a route in Nagaland that usually takes 3.5 hours on the road took just over 20 minutes by a drone. Even in a state with good roads like Telangana, a 46 km route translated to an aerial distance of 26 km. Healthcare delivery drones are capable of 90-100 km/hr speeds and are unaffected by traffic and road conditions.

Drone-based automated supply chains create a virtual cold chain. The end-health facility does not need to maintain an extensive and expensive cold chain and power backup infrastructure. Also, it is not practical for a CHC or PHC to collect and store multiple cold-chain products like blood. In an urban location like Bengaluru, one can order ice cream on Zomato and Swiggy and get it within 60 minutes. Imagine that level of service for ordering medical products in remote and rural locations. Under 60 minutes grocery delivery is a fantastic convenience, but under 60 minutess medical deliveries can be lifesaving.

There is a precedence of this service in Africa, where drone-based supply chain systems have been running for over four years. Drones deliver over 80 per cent of Rwanda’s blood supply outside the capital city of Kigali. Estimates suggest that overall, blood use went up by 175 per cent, and wastage and spoilage of medical products reduced by 95 per cent. Average delivery times went down from 4 hours to 30 minutes. In Ghana, over 300 drone routes serve 2,000 health facilities. Ghana was the first country in Africa to receive COVAX vaccine supplies due to its robust drone-supported vaccine delivery network.

Automated health supply chain systems result in several positive social, health, economic and environmental outcomes. They include increased health access and equity, reduction in time taken for medical deliveries, time savings for healthcare staff, reduction in mortality rates, improved immunisation rates, reduction in wastages, expiry and stockouts, reduction in diesel consumption, and skill development for local youth in technology.

Four elements are essential for successful implementations of drone supply chains: complete support of the government and public health system; centralisation of supply chain points; strong drone partners; and catalytic donor and philanthropic capital. The last element played a pivotal role in catalysing the technology in public healthcare. The Bill and Melinda Gates Foundation, UPS Foundation, GAVI, and many other corporate partners in Africa have played a critical role in supporting these governments.

Through PPP models, donors, foundations, and CSR can support state governments and healthcare drone enterprises in establishing district and statewide systems. Ayushman Bharat’s guidelines recommend expanding the range of services at the last mile as part of its ambitious programme of creating over 1.5 lakh health and wellness centers. Robust health supply chains will be critical in realising that dream and fulfilling India’s SDG-3 targets. u

a nshul s harma

Kundan

m adireddy

Anshul Sharma is

Co-founder and CEO, Redwing Labs; Kundan Madireddy is Head of Partnerships, Redwing Labs