By Ricardo Pires
18 March 2016 – Twenty-nine-year-old Melina Nkosi* had to wake up before dawn and walk for two and a half hours to reach the Matapila Health Centre, located in a small village 20 kilometres away from Lilongwe, Malawi’s capital city. She hopes that today she will finally get the good news for which she’s been desperately dreaming.
For almost two months, Melina has been waiting to get the result of her baby’s HIV test. She is tired from the commute but even more exhausted in her heart and mind.
“I feel guilty and in pain while not knowing if my baby is sick. I think about it every day — when I wake up, when I feed her, and even more when she cries. I don’t know if she is sick and if she is, she needs to get medicines. I just need to know if she has HIV or not,” she explains while holding three-month-old Pemphero tightly in her arms.
Unfortunately the result for little Pemphero wasn’t delivered as promised. While the healthcare assistant explains why to Melina, her eyes seem lost, as if looking for an absent solution. In 2011, she was diagnosed with HIV and since then has been taking antiretroviral drugs. She knows how vital the medicines are for someone who carries the virus.
Melina’s predicament is sadly common in Malawi. At present, infants get tested for HIV through dried blood samples that are taken at the community health clinic, then batched together and driven to one of the eight laboratories in Lilongwe that are equipped to analyse them.
With bad roads, expensive fuel and limited vehicles, the time taken between collection and delivery of results can take up to 10 weeks. The process isn’t moving fast enough and children are paying for it with their lives.
The situation has become so critical, with an estimated 10,000 children dying of HIV-related illnesses nationally every year, that the most efficient solution seems to have literally come from the sky.
The Government of Malawi and UNICEF have started to test Unmanned Aerial Vehicles (UAVs), or drones, to transport batches of dried blood samples and reduce waiting times for HIV testing of infants, which will result in faster access to treatment and save the lives of babies like Pemphero.
The use of drones, which in testing will carry only simulated samples, has the potential to cut waiting times dramatically — to only a few days. The first successful test flight completed the 10km route unhindered travelling from a community health centre to the Kamuzu Central Hospital laboratory.
Local residents gathered in amazement as the vehicle took off and flew away in the direction of the hospital. The test flights, which are assessing viability including cost and safety, will continue until Friday 18 March.
If successful, the initiative will be integrated into Malawi’s health system, alongside existing mechanisms such as road transport and SMS.
“HIV is still a barrier to development in Malawi. This innovation could be the breakthrough in overcoming transport challenges and associated delays experienced by health workers in remote areas of the country,” says Mahimbo Mdoe, UNICEF Representative in Malawi.
UAVs have been used in the past for surveillance and assessments of disaster, but this is the first known use of UAVs on the continent for improvement of HIV services.
“Malawi has pioneered a number of innovations in the delivery of HIV services including the Option B+ policy, which puts mothers on a simple, lifelong treatment regime. We have also pioneered the delivery of results from the central laboratory to the health facilities through text messages. We believe our partnering with UNICEF to test UAVs is another innovation and will help in our drive to achieve the country’s goals in HIV prevention and treatment,” said Dr. Peter Kumpalume, Malawi’s Minister of Health.
As HIV is still a major threat for children in Malawi, the possibility of achieving an AIDS-free generation in the country remains a distant possibility – although now, through innovation, a much more realistic one.
*Name changed to protect her identity
Ricardo Pires is the Regional Communication Specialist at UNICEF Eastern and Southern Africa Regional Office in Nairobi.