We haven’t considered the true cost of drone delivery medical services in Africa

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Image: Zipline
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The “Uber for” business model has exploded over the past several years, with countless Silicon Valley start-ups seeking to capitalize on the on-demand model made (in)famous by former CEO Travis Kalanick.

In a December 2016 article in Wired, over 500 companies listed on the startup/angel investor matchmaking site AngelList included “Uber for” in their company description. But, while Uber and copy-cat services like SafeBoda are disrupting transportation services in a number of cities in sub-Saharan Africa (for better or for worse), the “Uber for” model has yet to transform service delivery in other sectors on the continent.

Enter Zipline, a California-based start-up that has been getting a lot of press for its attempt to upend health commodity delivery in developing countries through the use of drones. In Rwanda, Zipline provides a service that is essentially “Uber for blood.”

When a patient comes in needing a transfusion, a doctor or healthcare worker sends a WhatsApp message or logs into Zipline’s ordering site to place an order. Back at the Zipline distribution center, a drone is packed up, launched and arrives at the clinic 20 to 40 minutes later, dropping the package near the clinic for the healthcare worker to retrieve.

In an extremely mountainous country like Rwanda that has only 25% of its 4,700km of roads paved, having access to a service like Zipline can mean the difference between life and death, as the patient stories documented on the company’s website can attest.

Since launching in 2016, Zipline’s “Uber for blood” service has been so successful that the company is now expanding its service into Tanzania—a country 35 times the size of Rwanda, with only 8% of its roads paved—and beyond blood into delivery of vaccines, anti-retrovirals, anti-malarials, and emergency medical supplies like sutures. Venture capital firms like Google Ventures and Sequoia Capital are betting big on Zipline’s continued success to the tune of about $43 million. But before the VC community gets too excited about its shiny new toy, perhaps they should take a step back and ask themselves if blind, rapid expansion into the provision of all health commodities should be the ultimate goal for this technology.    

There is a strong case to be made for using drones to deliver commodities and services where time is of the essence and cases are rare. This is true for blood transfusions for road accident victims or post-partum hemorrhaging, as well as for snake anti-venom, which health clinics do not often stock due to the infrequency of cases but which needs to be administered within hours in order to save the victim.

But treating someone for malaria or giving a child their third dose of a pentavalent vaccine is not a rare occurrence, and those commodities can and should be readily available at the health facility whenever a patient needs them. For these routine health services and commodities, you don’t need drones—you just need good forecasting and regular, on-time delivery.

Of course, this is not to diminish the challenge of accurately forecasting and ensuring timely delivery of these health commodities in low-income countries like Rwanda and Tanzania. If it were easy, there wouldn’t be multi-year, multimillion dollar programs in place trying to address it.

But while a high-tech fix looks great for the VC’s portfolio and perhaps a president’s re-election campaign, it ultimately distracts from a bigger underlying and decidedly un-sexy issue: lack of investment in infrastructure.

Investments in this type of “leapfrogging” technology allow developing country governments to shirk their responsibility for providing access to basic public goods and services—like essential medicines and quality transportation infrastructure—and, as a result, imposes significant externalities on the physical and economic welfare of its citizens.

What if the $25 million Zipline raised in Series B funding and the $15-$45 cost per delivery charged to partner governments were instead invested in paving, upgrading and maintaining roads in Rwanda and Tanzania? Better roads in these countries would do more than just help bring essential medicines to patients in need. They would give people access to markets where they can sell their produce and labor so that they can earn enough money to feed their family and put their kids through school.

Better roads would create jobs in construction, repair and maintenance that could combat the growing epidemic of youth unemployment across the continent. They would strengthen the infrastructure that is, as Calestous Juma recently stated, “both the backbone of the economy and the motherboard of technological innovation.” Employing a handful of people to staff a few Zipline distribution centers across the country can’t do that.

Zipline says that it provides a seamless delivery system at an affordable price. But the company and its funders are remiss to overlook the opportunity costs of this service to the longer-term growth and development of these countries and their citizens.

*The views expressed represent the author’s personal opinion and not that of any organizations or entities with which they are affiliated.