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Delivering vaccines by drone in Rwanda

Ground-breaking work by Dr Christopher Green, Associate Clinical Professor in Infectious Diseases at the University of Birmingham, is looking at how future disease outbreaks might be better controlled using unmanned aerial vehicles (popularly known as drones) to deliver vaccine doses to remote parts of Rwanda. 

This work is part of a wide programme of research by the Africa Centre of Excellence for Sustainable Cooling and Cold-chain (ACES), in designing and testing systems that will provide safe, reliable and sustainable cooling needs for future food and vaccine security in Africa. This research is intended to provide a real-world evidence base to policy makers and to aid public health planning.

Rwanda has well-developed vaccine cold-chain infrastructure and had high-levels of vaccine coverage before the Covid-19 pandemic, and was one of only four African nations to achieve World Health Organisation targets for Covid  vaccine deployment when these products arrived in the country. As lessons are learnt from the pandemic and preparations are made for new disease outbreaks, a lot of emphasis is on how new vaccines are rapidly manufactured and deployed to address new public health dangers. 

In particular, lipid-enveloped mRNA vaccines that were developed so successfully for Covid-19 are a type of technology very well suited for the speedy re-targeting against other pathogens, and a whole suite of new mRNA vaccines is entering clinical trials. The problem with mRNA vaccines is their short period of stability at fridge temperature.  This is typically a few weeks, meaning there is a need for ultra-cold long term freezer storage (which often does not exist in Africa) and new ultra-fast distribution systems for fridge temperature. 

Dr Green (pictured) and the team at the NIHR/Wellcome Clinical Research Facility (CRF) at University Hospitals Birmingham NHS Foundation Trust played a major part in Covid-19 vaccine development.  They have already turned their attention to three first-in-man non-Covid mRNA vaccine trials for this year, making the connection between experimental vaccine research and applied vaccine impact.  

This will be applied with real-world impact inconjunction with project partners like the national health implementation agency for Rwanda (Rwanda Biomedical Center) and UAV operators (Zipline Inc) who operate in multiple African countries to deliver critical medicinal products. 

Dr Green said: “As well as the significant challenge to re-design vaccine infrastructure to make the most of advances in new mRNA vaccines, we are focussing on the effects of climate change. Hot, unpredictable weather is a threat to the equipment and energy we currently rely on, and changes to the environment are also likely to result in changes to disease outbreaks and longer, more fragile vaccine deployment needs. 

“The capacity to be flexible and rapidly responsive will be important. Even today in Rwanda there are threats from disease outbreaks in nearby regions from Ebola and Lassa virus. 

These drones can launch and safely supply vaccines to within a six foot target area within 50 minutes to any rural area of the country.  

Rwanda is a small country with difficult terrain but it has a very mature and well led public health system, and the government is highly engaged in continuing to lead the way for other African nations. It is an exceptional pleasure to work with our partners there.”

There is scope to widen the innovative delivery method to include all childhood vaccines as well as the development of in-field immune diagnostics, also being developed at ACES and the Clinical Immunology Service.  To date, five NHS Infectious Diseases research fellows as well as NIHR CRF Birmingham research nurses and pharmacists have been involved in research projects and in building research capacity in Rwanda for future collaborations.

Dr Green adds: “The NIHR and NHS deserve much credit for enabling this work as part of our global health responsibility, together with the wider ACES team funded by Defra and the United Nations.  For the future, we are looking to strengthen the link between experimental and applied vaccine research at all levels so that vaccines can reach everyone who needs them.”


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