Lastmile delivery using drones

The technology solution solves the TB patients’ missed dose and unsupervised dose through virtual TB patients ‘adherence treatment, while the coronavirus situation in Cambodia is exacerbating and worsening. The drone technology solution will solve the unsupervised and administered dose of patients and transport the TB presumptive sputum’s to the public facility’s lab unit nearby for testing safely. The TB patients will receive the TB drugs, sent to them by the drone, and the drone will take the picture of the patients, while delivering and giving drugs to them. In addition, the drone will be used to take the TB presumptive sputum to the lab unit at the public health facilities nearby for testing, too. Once the result is announced, it will be recorded into the treatment information system. Concerned healthcare providers are informed, and the treatment can be started effectively both in the intensive therapy and continued therapy completion.    

In this Covid-19 pandemic, it is not safe for the community direct observed treatment healthcare workers and NGO field staff members to provide the drug for the TB patients directly. They are at risk of contracting the coronavirus. In addition, the Royal Government of Cambodia (RGC) has restricted the traveling throughout the country. The movement can be allowed, but the all travelers have to be self-isolated for 14 days. Therefore, the TB patients are highly at risk of unsupervised dose, while they are required to take the TB drugs every day in front of the NGO field staff members and healthcare providers.

Cambodia is still in the list of 22 highest burden of tuberculosis country in the world as per World Health Organization (WHO). Cambodia’s Tuberculosis incidence, prevalence and mortality rate have steadily declined over the past decades; however, there are concerns that TB case detection rate has fallen as well, resulting under diagnosis of TB. Looking at the mortality rate amongst non- HIV TB population, around 3000 TB patients died in the year 2018 (WHO Tuberculosis Profile Cambodia). Treatment coverage against the estimated incident of TB is 58% in Cambodia, which also depicts 42% cases, are missing.

Using the drone technology will solve the problems mentioned above. Operation ASHA will use the drone technology to transport the medications to the patients ‘house, and directly observed treatment (C-DOT) as usual, although the healthcare workers and NGO staff members are restricted., and the missed dose can be avoided within the intensive therapy (IP) and continued therapy (CP). The multiple drug resistant (MDR) can be avoided as well. The C-DOT healthcare workers can strictly monitor the patients. In addition, the drones will also use to transport the sputum of the TB presumptive to the lab unit of the public health facilities nearby.

Operation ASHA in partnership with the Team ZUPPA to facilitate easier and quicker delivery of medical supplies in such areas, by use of drones. Though through various government schemes medicines are readily available at free of cost to the TB patients, but the accessibility to this medication and the transportation of the sputum to the lab unit during this Covid-19 pandemic  is the main problem.
Using drone technology to deliver crucial medications to members in last mile distant communities affected by Tuberculosis during the coronavirus pandemic is an effective solutions to the TB patients in Cambodia.

The drone technology can serve the TB patients significantly and the healthcare workers. Although the Covid-19 situation continues, the C-DOT healthcare workers and NGO staff members can monitor the TB adherence treatment perfectly and safely. The medication can be delivered to the patients and the sputum of the TB presumptive can be transported to the lab unit at the public health facilities nearly effectively and efficiently. The missed and unsupervised dose can be monitored virtually, thus avoiding the multiple-drug resistant (MDR). As a result, the TB patients can complete their treatment, and their lives can be saved tremendously. The preventable death for the TB patients can be avoided. 

In fact, the solution is designed to respond to the current situation of the coronavirus pandemic in Cambodia. The drone technology solution, which is designed will address the desperate need of the TB patients in Cambodia that need to take the TB drugs every day without interruption, and with a directly observed (DOT) treatment by the NGO staff and healthcare providers.  

Operation ASHA’s Cambodia Office in partnership with the Headquarters in India and supplier to develop the drone technology to respond to the need of the TB patients in Cambodia. The drones will be used to transport the TB drugs and transport the TB presumptive sputum to the lab unit at the public health facilities nearby. The drong technology solutions will be applied with the TB patients in 9 provinces under Operation ASHA catchment areas in Cambodia, which has given full support by the National Tuberculosis Program (NTP), Cambodia.

• Sree Sai Aerotech Innovations Private Limited (SSAI), better known as ZUPPA, manufactures an array of technologically advanced products such as GPS Vehicle Tracking Systems, Telematic Systems and Drones (Unmanned Traffic Monitoring and Autopilot Systems).
• TEAM ZUPPA shall Team up with Operation ASHA to Create Fully “MADE IN INDIA” Autonomous RPAs to Deliver TB Treatment to Remote and Dispersed Reaches of Rural India.

It is innovative, indeed. The drone technology solution is first introduced to overcome the challenges of the TB patients during the novel coronavirus pandemic in Cambodia. Using the technology solution will overcome the TB patients ‘unsupervised and missed dose, thus saving the patients’ lives significantly during the novel coronavirus pandemic in Cambodia. The drones will be used to load and deliver the TB drugs from the public health facilities to the patients’ houses effectively. It will also be used to transport the sputum sample of the TB presumptive from the communities to the lab unit in the public health facilities nearby, efficiently. In an economic standpoint, the patients can swallow the TB drugs regularly, although the situation of the novel coronavirus is exacerbating and worsening. The physical contact of the healthcare workers and NGO staff members and the TB patients can be tremendously reduced, thus avoiding contracting the deadly novel coronavirus. The preventable death from TB patients can be tremendously saved. Moreover, the drone technology solution can also be used to transport the sputum of the TB presumptive from the communities to the lab units at the public health facilities nearby efficiently. The lab technician will test the sputum sample, and if the result is positive, it is subsequently entered into the e.Alert application, and shared with all concerned healthcare workers. The patients will receive the treatment immediately. They are not required to go the public health facilities physically, but the drone technology solution, including adherence treatment as well.

In this 2021, Operation ASHA has served 131,112 TB patients. Of these, 86,835 are female TB patients. In 2022, Operation ASHA will be served 136,164 patients. Of these, 136.164 targeted TB patients, 46,296 are females. The male to female TB ratio was 1,51: 1 among smear positives (S+) and culture positive (C+), whereas the male to female ratio was 1,48:1 among smear negatives (S-), and culture positive (C+), according to the National Tuberculosis Programme (NTP), Ministry of Health (MoH). In 2025, the project will serve 655,560 TB patients in Operation ASHA target areas. This includes the coverage areas of 30 operational districts, 367 health centers in 9 provinces, Kingdom of Cambodia.

The drone technology solution project contributes greatly to the UN Sustainable Development Goals (SDGs), dubbed goal 3, good health and well-being of the people. The close contact with BK+ patients receives the preventive TB treatment regularly, thus preventing them from further contracting others in the communities. In addition, CTS-V, CTS-P and RCTS are regularly tracked through the M&E tracking system to make sure that the agreed set indicators are achieved. The M&E tools have been developed. This includes the master plan data tracking system, TPT, HL data tracking templates, amongst other things. Moreover, Operation ASHA will commission the external evaluators to the conduct the mid-term review and final project evaluation to make sure that the impacts and the progress are achieved.  

The drone technology solution for health of Operation ASHA employs 41 full time staff members. 8 of them work in the central command center, based in Phnom Penh, and 33 staff members work to coordinate the regional command center in 30 operational districts in the Southwestern region of Cambodia.

The team has extensive experience working to introduce the technology for health in Cambodia since 2010. The organization have introduced a number of technology applications to detect the TB presumptive, dubbed e.Detection, to enroll the patients for immediate treatment into the system through the e.Compliance whereby the patients are monitored digitally when the swallow the TB drugs. In addition, the e.Alert and e.Counseling have already been introduced. Moreover, the human resources for health of Operation ASHA have been working in the communities to implement the community directly observed treatment (C-DOT) in 2015. The project-design and development processes have been combined on evidence-based project development on the spot in consultation with the concerned partners. This includes the national tuberculosis programme and the local health authorities at the community level. It is expected to see that the drone technology solution for health will fully address concerns and issues of the TB patients well.  

Indeed, the leadership team of the drone technology solution for health of Operation ASHA is a diverse, equitable and inclusive. The team members are composed of the healthcare workers, local health authorities, ranging from the national tuberculosis programme (NTP), the provincial health department (PHD), operational district(OD)and health center (HC), community health support group or (VHSG) who work closely with the TB patients on the ground. In addition, the patient representatives of the TB affected community are included into the drone technology solution for health. Each and every operational district, within the sub-regional command center, patient representative along with the healthcare workers of the government system is included. In so doing, the technological transformation knowledge can be transferred for sustainable development. 

The solution can be implemented to respond to the concerned and issues of the TB patients that desperately in need of support.

It would be good if the areas mentioned above can receive the support so that we can improve our solutions, and other solution in the future.

Operation ASHA really need any support from the MIT faculty or initiatives and Solve Members.

Operation ASHA is working to respond to the last mile delivery of the TB patients in rural India, Cambodia and other regions of the world. Therefore, the Global Fund Prize is suitably qualified for it.