DHEPLab researchers have published findings from a landmark cluster-randomized controlled trial evaluating drone-based medical supply delivery in remote Madagascar in BMJ Global Health.
Led by Associate Professor Kat Tumlinson, with co-authors Sean Sylvia and Tara Templin, the study titled “Wings of access: a cluster RCT on drone-based medical commodity delivery in remote Madagascar” is the first rigorous randomized trial to evaluate drone delivery of essential medicines in the Global South.
The trial randomized 109 hard-to-reach public health facilities in eastern Madagascar to either drone-supported or standard land-based delivery. Despite 1,551 successful drone flights transporting vaccines, contraceptives, malaria tests, and other health commodities, the intervention did not measurably reduce most stockouts or increase contraceptive use.
“Drones were able to reach facilities that are extraordinarily difficult to access, so the problem was not that the technology failed,” said Tumlinson. “What the trial showed us is that faster transportation alone is not enough. A health system also must know what is on the shelf, anticipate what will run out, and act on that information before patients arrive to find that the medicine they need is unavailable.”
The findings suggest that drone delivery alone may be insufficient to improve commodity availability where upstream supply-chain constraints remain binding. The research underscores the importance of addressing information systems, ordering processes, and procurement bottlenecks in addition to transportation infrastructure.