Review Article

Unmanned aerial vehicle (drones) in public health:

A SWOT analysis
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Karthik Balajee Laksham1

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Department of Community Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER),
1

Karaikal, Puducherry, India

A bstract
In developing countries, lack of access to roads is critical for medical supplies like vaccines and drugs. Air transport like a helicopter
is expensive and not affordable. The success of drones in the fields of ecology and environment makes us believe that they can also
be used in the field of Public Health as medical couriers. The important strength of using drones is its potential to decrease the
travel time for diagnosis and treatment. They are a cost-effective alternative to road transport in difficult terrains. Drones can be
used in the transport of blood from the blood bank to the place of surgery and that of specimens from hard-to-reach areas to the
labs in nearby towns. They can deliver essential medicines like anti-venom for snake bite and dog bite and prevent deaths. Drones
can be employed in disaster relief operations for rescuing victims and in the delivery of food, water, and medicines. Organs can be
transported in a short time bypassing the busy traffic. However, operating drones require trained staff and the lack of infrastructure
like runway is a potential problem. Drones cannot carry heavier payloads or deliver goods long distances. Drones in the hands of
terrorist groups may be weaponized and used for terror attacks. Medical drones may be mistaken for military Drone and attacked
by armed forces.

Keywords: Unmanned Aerial Vehicle, drones, Public Health, SWOT analysis

Introduction cameras are piloted remotely using a smartphone or a computer

in environmental studies for aerial air sampling[1] and monitoring
Unmanned Aerial Vehicle, commonly known as Drone, is a greenhouse gases, [2] occupational hygiene, [3] construction
small aircraft which fly by remote‑controlled operation. When industry for safety management,[4] pedestrian behavior study
we speak about drones, we think about a battlefield, destruction, and pedestrian‑vehicle crash analysis,[5] wildlife monitoring,[6]
and death. This is because of the fact that the drones have been and in landscape ecology as in the study of malaria associated
conventionally used by the armed forces to drop bombs and with rubber plantations.[7]
destroy enemy targets. These are called the military drones.
Apart from this destructive purpose, there are other potential Medical Drones
uses of drones as well. They are increasingly being used for
civilian and commercial purposes for the delivery of smaller In developing nations and in areas with mountains, deserts, or
items to locations with difficult access. They provide fast access forests, roads are impassable and take long‑distance travel. Lack
to images as well as real‑time videos. Drones equipped with video of access to roads is critical for medical supplies such as vaccines
and drugs. Air transport like a helicopter is the only alternative
so far, but it is expensive and not affordable to the patients or
Address for correspondence: Dr. Karthik Balajee Laksham,
Department of Community Medicine, Jawaharlal Institute of
the health system. The success of drones in the fields of ecology
Postgraduate Medical Education and Research (JIPMER), Karaikal, and environment makes us believe that they can also be used
Puducherry ‑ 609 602, India.
E‑mail: [email protected]
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Access this article online
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DOI: How to cite this article: Laksham KB. Unmanned aerial vehicle
10.4103/jfmpc.jfmpc_413_18 (drones) in public health: A SWOT analysis. J Family Med Prim Care
2019;8:342-6.

© 2019 Journal of Family Medicine and Primary Care | Published by Wolters Kluwer ‑ Medknow 342
 Laksham: Drones in public health

in the field of Public Health as medical couriers. A study from When drones are used for medical purpose, there is a
the Johns Hopkins University School of Medicine has shown possibility of job loss for those who are currently involved
that the transportation of laboratory specimens via drones does in the transport of medical products. But new staff will be
not affect the accuracy of routine biochemistry, hematology, recruited to operate the drones.
and coagulation test results.[8] In the United States, the first 2. Technical Limitations
government‑approved delivery of medical supplies by drones Unlike commercial planes and helicopters, drones cannot
occurred in July 2015.[9] This gives us the confidence in employing carry heavier payloads or deliver goods long distances. The
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drones in the transport of medical supplies to remote, difficult payload of a drone varies between 2 and 4 kg.[11] The smarter
to access areas. Dr. Margaret Chan, the former Director‑General a drone, the weight, and its cost would increase. The safety
of the World Health Organization, has said “The use of drones and efficiency of drones are not well established. Biological
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to deliver lifesaving medical products can overcome the lack samples are fragile and need a proper package to prevent
of infrastructure. We need to let our imaginations soar when tampering in transit. In order to transport drugs/vaccines, ice
looking for ways to get quality medical products to those in packs or coolers have to be inbuilt in drones to maintain cold
greatest need.”[10] chain. The battery life of drones is a concern, which can be
addressed by using solar‑powered drones like the Aquila by
SWOT Analysis Facebook.[16] Drones can be programmed to a return‑to‑safe
location if the battery is low or communication is lost. The
In this review paper, I have assessed the application of drones tolerance of drones to adverse environmental conditions like
in Public Health using the SWOT analysis technique. SWOT wind and turbulence is not clear. Electromagnetic interference
is an acronym for Strengths, Weaknesses, Opportunities, and has disturbed the signal reception in the monitoring of drones
Threats. This analysis will be useful to assess the likelihood of a from the ground.[17]
drone’s success or failure in public health. Articles on drones were 3. Regulations and Legality
searched in PUBMED and Google scholar. Cross‑references A major hurdle in the use of medical drones is the legal
from these articles were also obtained. Articles on drone usage in permission from Aviation authorities. The use of drones for
military or warfare were excluded. The strengths and weaknesses commercial purpose is not permitted in India. In the United
inherent to drones and its usage in public health are identified. States, under the Federal Aviation Administration (FAA)
The opportunities and threats which may likely arise from the rules, license to fly UAV is granted, provided, the drone
external environment are also assessed so that they can be utilized must weigh less than 25 kg and must remain within the
and avoided, respectively. The analysis is presented under the visual line‑of‑sight (VLOS) with maximum ground speed of
aforementioned four headings. 100 miles per hour and a maximum altitude of 400 ft above
ground level.[18]
Strengths
Opportunities
The important advantage of using drones is its potential to
decrease the travel time for diagnosis and treatment. Patients The potential use of drones in the field of public health is
within a 4.6 square mile radius can be reached by a drone in a enormous and it is expanding. Some of them are listed below:
minute which is 10 times faster than conventional emergency a. Transport of Blood, Medicines, and Biologicals:
services.[11] Drones are a cost‑effective alternative to road 1. In developing countries, such as India, there is a shortage of
transport in difficult terrains. A simulation model has shown safe blood in hard‑to‑reach areas.[19] Drones can be used to
that the drones could increase vaccine availability and decrease transport the blood, required for transfusion during surgery
the costs.[12] As drones fly close to the surface of the Earth, or delivery, from blood banks in cities or towns to a remote
the limitations associated with satellite images, such as cloud health center. This will avoid the need to set up blood
contamination, are overcome by drones and they can provide storage facilities in rural health centers and save costs. They
accurate data.[13] Drones can be operated in difficult areas, such can also be used to deliver blood to mass casualty scenes.[20]
as mountains, canyons, or snow‑covered ground, and assisted The Rwanda Government is involved in delivering blood
rescue teams in searching and documenting missions.[14,15] using drones to clinics located in hard‑to‑reach areas in a
short time and at the cost of motorbike delivery.[21]
Weaknesses 2. In rural areas, the delay in diagnosing diseases due to lack
of laboratory facilities can be overcome by the use of
There are some limitations of deploying drones in public health. drones. Health workers can be trained to collect samples
They are as follows: from patients and send them to the nearest laboratory by
1. Manpower and Infrastructure drones. The results can be sent back to the health worker
Operating drones require trained staff and continuous along with medicines if tested positive. In Madagascar,
monitoring from the ground. Lack of infrastructure like drones have been used successfully to transport blood
runway is a potential problem; however, it can be overcome samples from villages without diagnostic facilities to
by using drones having vertical takeoff and landing. laboratories in cities.[22] In Malawi, dried blood sample

Journal of Family Medicine and Primary Care 343 Volume 8 : Issue 2 : February 2019
 Laksham: Drones in public health

from infants, to test for HIV, have been transported huge damage.[37] An accidental collision of a commercial
using drones.[23] Sputum samples to detect tuberculosis drone had caused depressed skull fracture in a 13‑year‑old
have been transported from a remote village to Kerema boy.[38] In a recreational drone misadventure, a 9‑year‑old boy
city in Papua New Guinea.[24] suffered a traumatic ocular injury with full thickness corneal
3. Drones can deliver essential medicines like anti‑venom for laceration.[39] Apprehension among the public exists due
snake bite and dog bite, which will prevent deaths from these to fear of military drones. Attacks by military drones have
causes in rural areas.[25] Drones can be used to transport increased mental health disorders like anxiety in Pakistan.[40]
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samples and medicines in hospitals from one floor to another Civilian drones in the hands of extremists or terrorist groups
or from one building to another. Inside homes drones may be weaponized and used for terror attacks. As a security
can help elderly persons in bringing medicines and water. measure, transducers can be attached to track a drone.
2. Safety of the Drone
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Millions of women in developing countries have an unmet

need for contraception. Contraceptives can be transported Medical drones may be mistaken for military Drone and
through drones to rural areas of difficult access, where health attacked by armed forces. There is also a possibility of losing
staff can collect them and distribute to the beneficiaries. the package carried by the drones. Hackers can hijack a
In Ghana, the United Nations Fund for Population Drone using GPS jammers and loot the Drone or its payload.
Activities (UNFPA) together with the Government of the Softwares resistant to hacking have to be developed.
Netherlands has successfully delivered condoms to rural 3. Air Traffic Congestion
areas that are difficult to access by road.[26] Drones may interfere with air traffic and cause confusion to
b. Medical Emergencies and Disaster Relief commercial planes. In the United States, drones have delayed
In disaster relief operations, drones can be employed in aerial firefighter planes deployed to fight fire in California.[41]
rescuing victims from collapsed buildings or in searching
fishermen lost in the sea. They can be employed in the delivery Future of Medical Drones
of food, water, and medicines in case of disaster relief and
to those injured patients in offshore ships. A drone can serve From the above analysis, it is evident that drones have great
as an ambulance during emergencies.[27] They can transport opportunities in the field of public health. They can be used to
devices, such as Automated External Defibrillator (AED), to transport blood, specimens, and biologicals, such as vaccines to
the site of an out‑of‑hospital cardiac arrest in a short time remote places, and reduce the travel time. They can be employed
and increase the survival.[28,29] AED‑equipped drones can in disaster relief and save lives. Though there are weaknesses and
give visual feedback and assist a bystander to provide Cardio threats in the application of Drones, they can be overcome with
Pulmonary Resuscitation (CPR) to out‑of‑hospital cardiac the advancement in technology and research. Drone delivery
arrest patients.[30] Drones transmitting video is time saving systems and drone delivery ports could be constructed near
and efficient in locating drowning victims and in delivering health care systems. Assessment of public safety and privacy
a flotation device in comparison to surf‑lifeguards.[31,32] has to be done before scaling up of drones in public health.
c. Organ Transplantation More studies are needed on the safety of drones, including
One of the biggest challenges in organ transplantation is in drone crashes and the reason for crashes. There is also a need
moving the donated organ from the facility where it is harvested for health education to alleviate the apprehension about drones
to a recipient admitted at another distant hospital in the shortest in people’s mind.
possible time. To avoid the delay in this transport, traffic police
departments usually create a Green Corridor by blocking the Financial support and sponsorship
traffic and making way for the ambulances carrying the organs. Nil.
[33]
With the use of drones, organs can be transported in a short
time bypassing the busy traffic.[34] Kidneys transported in drones Conflicts of interest
did not show damage related to extrinsic forces.[35] There are no conflicts of interest.
d. Surveillance in Difficult Areas
Surveys that are inaccessible by ground can be done rapidly
using drones. In March 2011, following the Earthquake and
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