UAVs In Global Health - United States Agency For .
UAVs in Global HealthDefining a Collective Path ForwardFrom CII’s Innovating for Impact Series
USAID’s Center for Accelerating Innovation and Impact (CII) takes a businessminded approach to fast-tracking the development, introduction and scale-up ofhealth interventions that address the world’s most important health challenges.CII invests seed capital in the most promising ideas and novel approaches, usingforward-looking business practices to cut the time it takes to transform discoveriesin the lab to impact on the ground.A tremendous amount of work went into the development of UAVs in GlobalHealth: Defining a Collective Path Forward. USAID would like to thank our team ofadvisors and reviewers for their invaluable input, including experts across USAID.We are especially grateful to the Boston Consulting Group for their partnership indeveloping this work. Questions and comments are welcome and can be directedto the USAID leads for this guide, Marissa Leffler and Jennifer Fluder.For contact information, and to download the latest version of UAVs in GlobalHealth: Defining a Collective Path Forward, please visit www.usaid.gov/cii
CONTENTS
1. ForewordWe at CII believe that innovation is only meaningful if it leads to impact. This is no more so true than with the potentialof UAVs in global health. Over the last few years, we have learned a lot about the role UAVs can play in the humanitarianspace. Many donors, including USAID, have made investments in many pilot projects in many different countries across manydifferent use cases to test the efficacy of UAVs. We’ve seen both promise and skepticism.Given these advances, we thought it was the right time to take stock of what we’ve learned and to define a collective pathforward. To do so, we have engaged diverse perspectives across many sectors, including Ministries of Health, humanitarianorganizations, donors, UAV startups, logistics companies, and beyond; reviewed existing studies and literature on UAVs inthe development space; assessed market shaping opportunities; and analyzed the leverage points and roadblocks likely tobe encountered in moving on-the-ground UAV pilots from concept to scale.The good news is there’s so much promise, but only if we work together. We are hopeful that the analysis and investmentroadmap found in UAVs in Global Health: Defining our Collective Path Forward will create better alignment across various UAVactors – including donors – and motivate smarter investments and development that can accelerate the cost-effective andsustainable use of UAVs in global health.As with all our work, we hope you take a critical look, put this analysis to the test, and join us so we can move forward fasterand smarter. We look forward to hearing from you.David MilestoneActing Director, Center forAccelerating Innovation andImpact, USAID4Jennifer FluderSenior Innovation and PartnershipAdvisor, Center for AcceleratingInnovation and Impact, USAID
2. IntroductionOpportunity for UAVs in GlobalHealthSanjiv Singh of the Robotics Institute at Carnegie MellonUniversity describes three uses for UAVs1: to reach beyondcameras to enable a new point of view, to reveal newinformation by collating data from multiple sensors, and totransport materials.To date, the broadest uptake of UAVs globally has beenin the first two categories, as relatively inexpensive UAVbased cameras have supplanted other forms of aerialimaging. While the defense and intelligence sectors werethe earliest adopters, the development sector has begunto use UAVs to ‘reach’ and ‘reveal’ as well. Hundreds ofimaging flights have been successfully carried out in serviceof humanitarian missions, including surveillance followingnatural disasters and vector research for malaria.The use of UAVs to ‘transport’ materials has also beenexplored. Militaries have created a suite of UAV systemswith large scale transportation capabilities, and commercialentities are investing heavily in drone delivery services. AsUAV technology improves, it is likely that the use of UAVsfor logistics in global health will become increasingly viable;in fact, several pilots are already exploring this opportunityspace.The potential benefits of UAVs within global health areextensive. In particular, the demand for UAVs to transportmaterials is increasing. UAVs can fly over vast distancesand challenging terrain, enabling just-in-time delivery oflife-saving medical supplies to those in hard-to-reachcommunities. The technology could also improve accessto non-emergency commodities for villages where healthworker visits and commodity deliveries are infrequent, andin emergency settings it could greatly reduce responsetimes. When deployed effectively, UAVs could bringmeaningful benefits to global health through improvedsupply chain performance and health outcomes.FIGURE 1: Evolution of UAVs from military origins to humanitarian and commercial useMILITARY ORIGINSFirst UAVflightsduring WWI1916Firstrecondrone1955COMMERCIAL USEFirst modernUAV withlive video1973Dominos ParcelCopterDomiCopterby DHL 2005 2010Post-KatrinadamageassessmentEarthquakein Haiti20112012Fukushimasurveillance2013Search &rescue inCanada20142015Amazon UPSPrime demoAirin US20162017Migrant rescue Landslidein Mediterranean risk inEcuadorHUMANITARIAN USE1While the term UAV (unmanned aerial vehicle) is used throughout this paper, this should be interpreted as broadly inclusive and synonymous with drones, UAS,aerial robots, and other similar terms.5
Current State of UAVs in GlobalHealthWhile UAVs’ dynamic feature set and capabilities makethem a potential game changer in global developmentand humanitarian use, it is important to acknowledge thatadoption of UAV technology in global health is still at anascent stage.Even at this early stage, UAV programs and pilots aregenerating useful learnings that will help fuel furtherdevelopment. Past pilots serve as initial proof of conceptthat UAV technology can work in the global health context,and several studies have been conducted to demonstratethe conditions under which UAVs might be cost effective.Best practices have been captured and shared with others,and the Humanitarian UAV Network has created a Codeof Conduct to ensure safe and effective use of UAVs inhumanitarian and development settings. Today, the potentialof UAVs is being explored further in the drone testingcorridor established in Malawi through coordination ofUNICEF and the government of Malawi.Experience from specific programs and pilots will also helpsmooth the path for future use by teaching us how to engagecritical stakeholders. Zipline’s commercial operations inRwanda have demonstrated that health ministries may bewilling to pay for UAV delivery in a fee-for-service model.Vayu’s experience with regulators has led to a betterappreciation for the range of stakeholders that must beconsulted and the intricacies of the regulatory pathway.And WeRobotics Flying Labs, currently in Peru, Tanzania,and Nepal, are building local capacity that will ultimately berequired to operate and maintain UAVs in-country.A number of working groups and informal coalitions havealso been established, ranging from the UAV PayloadDelivery Working Group (UPDWG) to the UAViatorsnetwork. While these groups have made meaningfulcontributions to advance the use of UAVs, deepercoordination and collaboration is needed to acceleratedevelopment and appropriate application of this technologywithin global health.FIGURE 2: History of UAVs in global health6JAN ’13JUN ’14SEP ’14MAR ’16JUL ’16OCT ’16JUN ’17Delivery ofmedicine andother suppliesin DR and HaitiTest deliveryof AED forcardiac arrestin SwedenMSF partnershipwith Matternetin PapuaNew GuineaUNICEFtesting ofDBS transportin MalawiPilot of Vayusample transportin MadagascarLaunch of Ziplinecommercial servicein RwandaUAV testingcorridor inMalawi
3. Our ApproachCall to ActionApproachTo build upon past efforts and unlock the future potentialof UAVs in global health, additional action and investmentwill be required. A broad community of users, funders,innovators, and implementers must work together toidentify the most pressing needs as well as prioritize andcoordinate future efforts to ensure that resources aredeployed efficiently and benefits are maximized.A broad, consultative approach was taken to documentthe current landscape and develop recommendationsto accelerate the field. This began with a comprehensivereview of existing literature, including FSD’s Drones inHumanitarian Action, SESAR’s European Drones OutlookStudy, and USAID’s Unmanned Aerial Vehicles LandscapeAnalysis. Additionally, the team attended a working sessionof 45 experts convened by the Center for Strategic andInternational Studies in April 2017. To supplement thispreliminary research, more than 20 interviews wereconducted with experts across sectors, including UAVinnovators, NGOs and humanitarian organizations,implementing partners, Ministries of Health, global healthfunders, aerospace industry leaders, and academia.As UAV innovators continue pushing the bounds oftechnology, a range of additional stakeholders will also needto be engaged to support the development of a broaderecosystem. The automobile industry is a helpful analogueto show the key contributions of varying stakeholdersin order to optimize the industry’s impact and reach:automakers continue to innovate as they manufacture cars,highway authorities or private sector players build andmaintain roads, and governments play an important role inensuring traffic safety.Over time, greater alignment and coordination acrossinnovators, manufacturers, implementers, governments,beneficiaries, funders, and other stakeholders will helpUAVs achieve scale. The purpose of this paper is to aligndonors and other stakeholders around opportunities tocatalyze development and scale-up of UAVs in global healthas efficiently and effectively as possible. The proposedinvestment roadmap will help bring clarity and focus tofuture efforts based on a shared understanding of thecurrent landscape and the challenges anticipated as UAVstransition from initial concept to wide-scale use.Developed exampleuse casesTested in Idea to ImpactframeworkTo understand the journey that UAVs will take as theymove from concept to scale, three example use caseswere developed, based loosely on current UAV projects.The use cases were taken through a modified version ofUSAID’s Idea to Impact framework, which was adapted tofocus on activities specific to UAVs. This holistic assessmentof the scale-up journey for different UAV use cases led tothe categorization of activities that can be accomplishedrelatively easily versus those which are more likely togenerate challenges.With a collective view of both opportunities and challenges,a proposed investment roadmap was developed andvetted in an incubator with relevant funders interested inaccelerating the UAV market for global health.Identified challengeareasDeveloped investmentroadmapSTAGE 1IDENTIFY NEEDSAND DESIGNBEGINR&DSTAGE 2STAGE 3PLAN FORINTRODUCTIONINTRODUCEAND SCALESTAGE 47
4. Investment TimelineOlandscape revealed that many pilot projects have beendriven by a desire to test the use of UAV technology invarious settings, rather than a careful analysis of specificproblems and a determination that a UAV-based solutionwas best suited to address these challenges.ur analysis uncovered several opportunities andchallenges that would benefit from coordinatedinvestment across multiple stages. It is proposedthat Stage 1 would entail cataloguing the efforts of existingworking groups and committees considering UAVs inglobal health, and standing up a coordinating body to helpsteer future activities across donor groups. Stage 2 wouldthen address near-term opportunities, and two subsequentstages could follow in the mid- to longer term.A second near-term opportunity is the creation andapplication of a standard approach to evaluate costeffectiveness, followed by a measured effort to improve thedata required for such an evaluation. This project showedthat there is currently no standard assessment process, yetcost effectiveness assessments are necessary to ensure thatprioritized use cases have a path to economic sustainabilityand to evaluate whether and for which parameters healthoutcomes are significantly improved. Cost effectivenessassessments should consider supply chain and healthbenefits alongside any cost savings or increases.They requirethe availability of baseline data on desired health outcomes,including estimation of interventions not provided due tolimitations in physical access to commodities. Each of thesetwo near-term opportunities is discussed in more detail inthe following section.In Stage 2, the first near-term opportunity is fosteringgreater, more purposeful, and proactive collaborationamong funders, with input from implementers and countrygovernments, to define and prioritize the most meaningfuluse cases for UAVs in global health. Use cases are theapplications of UAVs to specific problems, and shouldinclude sufficient details of the mission to define technologyrequirements. These requirements will inform one or moretarget product profiles (TPP), which will help identifyshared designs that could serve multiple use cases and willallow manufacturers to tailor products to the needs andconstraints of global health. This assessment of the currentFIGURE 3: Four stages of the proposed investment roadmapCatalogue existing working groups andcommittees exploring UAVs for globalhealth, and stand up a coordinating bodyto help align and steer future effortsSTAGE 1Conduct foundational analysis to createa better understanding of the sector andthe potential use cases that exist within itSTAGE 2STAGE 3STAGE 4Short term8Medium termLong termMake targeted investments in individualuse cases to address roadblocks andconfirm hypotheses on the UAV sectorWith a better understanding of markettrajectory, invest strategically in largescale challenges most likely to restrictgrowth of the sector
To address these two opportunities, it is recommendedthat Stage 2 of coordinated investment be focused onfoundational analysis to identify and understand the highestpotential areas where UAVs might be deployed in globalhealth. This effort would include defining clear criteria toevaluate use cases, assessing and prioritizing use casesalong these dimensions, analyzing use case economics andevaluating effectiveness, and ensuring that the technicalrequirements of use cases can be translated into targetproduct profiles. Foundational analysis should also includean assessment of gaps versus requirements in technology,infrastructure, and regulations. In this analysis, benchmarkingcurrent system costs and reach will be necessary to gainan honest appreciation of UAVs’ potential sustainability.After this foundational analysis is complete, funders andother stakeholders will have the information they need todetermine whether further investment is appropriate andhow such investments should be directed.Two additional stages of investment are also envisioned. InStage 3, donors would select specific, high priority use casesand support them with targeted investments to acceleratethe path to scale. Stage 4 would include investment inlarger scale, cross-cutting challenges that could acceleratethe path for multiple use cases, but may be more costlyand complex to resolve. These might include investmentsin technology, infrastructure, and/or regulatory pathways.These additional investments in Stages 3 and 4 may followStage 2, or may happen in parallel depending on donorappetite and the readiness of use cases and countries forfurther investment.In Stages 3 and 4, investment should be targeted to addresschallenges anticipated on the scale-up journey for UAVtechnologies. By applying USAID’s Idea to Impact frameworkto three example UAV use cases, including blood delivery,two-way sample transport, and vector control, five specificchallenge areas were identified that could prevent UAVsfrom reaching full scale in global health if donors and otherstakeholders don’t intervene. The challenges that wouldlikely come into play for the next stages of investment canbe seen in Figure 4 below.By following the proposed multi-stage investment pathway,initial investment will create better alignment on thehighest priority opportunities in global health. The resultsof foundational analysis will enable funders to better targettheir support and bring the most promising use casesforward. They will also generate greater clarity aroundmarket trajectory which will help de-risk more significantlong-term investments in cross-cutting challenges.FIGURE 4: Anticipated challenge areasCHALLENGE AREAREQUIREMENTSTechnology andmanufacturabilitySolve technical problems for UAV implementation;find manufacturer(s) who can produce to technicalspecifications at target costInfrastructureBuild the necessary infrastructure to support UAVs(e.g. runways or catapaults, cellular and satellitecoverage, maintenance, air traffic management, etc.)Regulations and policyNavigate regulatory and policy pathways at a global,national, and local levelCommunity engagementEngage the community to build trust in thetechnology and ensure safety and security of UAVsBusiness modeland partnershipsIdentify business models that enable sustainabledelivery of UAV solutions9
5. Opportunities forNear-Term InvestmentAnalysis of the current UAV landscape revealedtwo key opportunities for near-term investment.The first is the opportunity to better define andprioritize the highest potential use cases for UAVs in globalhealth, and the second is the creation and application of astandard approach to evaluate cost effectiveness.While many pilots have taken place and many innovatorshave expressed interest in testing UAV concepts in globalhealth, there is not yet sufficient information to understandwhich use cases have the potential to generate the greatestimpact in the most effective way.To serve as effective stewards oflimited funds, donors should supportfoundational analysis that will ensurefurther investment in UAVs is directedtoward the pilots, projects, andprograms that address the biggestchallenges and create the mostmeaningful benefits.It is envisioned that an aligned group of donors willaddress both of these near-term opportunities throughfoundational analysis in Stage 2 of the proposed investmenttimeline.Defining Use Cases and TargetProduct Profiles (TPPs)Use cases are the specific applications of UAVs to globalhealth problems, and require clarity around both theproblem statement and the intended solution. In thecurrent landscape, many UAV projects have focused ondeploying UAVs in global health without a clear analysisof whether UAVs are the most cost-effective way to solvethe problems at hand. As the sector transitions from pilots10to larger projects with potential for meaningful uptake andimpact, a shift in approach is needed. Stakeholders in keycountries should be consulted to help more clearly definethe specific logistics challenges faced in global health. Thiswill allow donors to determine where UAVs are betterpositioned than other technologies or investments toaddress these challenges.Use cases may start broad (examples could include ‘cargodelivery’ or ‘aerial mapping’), but additional detail will berequired to translate a use case into technical specificationsand a Target Product Profile (TPP), and to assess costeffectiveness.This should include key mission characteristicssuch as distance traveled and volume of cargo, as well asrequired capabilities such as remote landing and takeoff. AsTPPs are defined for priority use cases, opportunities mayarise for shared UAV designs which could address multipleuse cases. Coordination of stakeholders around desiredattributes would help innovators understand where designscould be standardized, which is likely to create advantagesfor scale and efficiency over time. This coordination couldtake place not on
Center for Accelerating Innovation and Impact (CII) takes a business- . global health, and standing up a coordinating body to help . use cases for UAVs in global health. Use cases are the applications of UAVs to specific problems, and should
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Wider Development Contexts Dylan O’Driscoll University of Manchester 14 August 2017 Question What uses have UAVs had in humanitarian relief and wider development contexts? Are there potential future uses within a development context that have been identified from other non-develop
for a wide range of geological, civil/mining engineering applications and projects. One of the most common uses of UAVs is 3-Dimensional (3D) mapping, with numerous applications in topographic surveys,
rithms, enable the development of small UAVs for Intelligence, Surveillance and Reconnaissance (ISR) mis-sions operating for extended periods of time over large geographical areas. The development of small inex-pensive UAVs will allow a exible and robust di
in this chapter will be a detailed breakdown of the pipeline survey process. After this a review of the strengths and weaknesses of the different types of UAVs will be presented. 2.2 Surveys undertaken prior to and during pipeline construction Pipeline surveying consists of sequential steps. Following is a brief description of these steps.
nonlinear control algorithms. Fig. 1: Skywalker X8 Fixed-Wing UAV Examples of nonlinear control methods applied to UAVs include gain scheduling [3], linear parameter varying (LPV) control [4], dynamic inversion (feedback linearization) [5], adaptive backstepping [6], sliding mode control [7], nonlinear
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