2020 IEEE International Symposium on Technology and Society (ISTAS) | 978-1-6654-1507-1/20/$31.00 ©2020 IEEE | DOI: 10.1109/ISTAS50296.2020.9462187 “Killing Two Birds with One Stone”? A Case Study ofDevelopment Use ofDrones Ning Wang Institute ofBiomedical Ethics and History of Medicine (IBME) University of Zurich Zurich, Switzerland ning.wang@ibme.uzh.ch Abstract—With the rise of the “humanitarian drone” in recent years, drones have become one of the most controversial public interest technologies that have gained increasing media attention. It is worth noting that, although there is a perception in the aid sector that drones hold the promise to reinvent the health supply logistics, to date, routine drone delivery is still relatively new and largely unproven. This paper presents a recent field study conducted in 2019, where drones were deployed in Malawi to help address the last mile challenge in medical supply delivery, and where a noticeable mentality of “killing two birds with one stone” around the attempt of using drones in resource-poor settings is observed. The objective of the paper is to shed light, through a real-world case study and from the ethical perspective, on the impacts of implementing such a systemic change in the existing health supply chain systems. As conclusion, a call for more reflexive approaches for the critical examination, as well as more structured guidance for the responsible evaluation, of medical cargo drones is raised. Keywords—public interest technology; humanitarian drone; medical supply delivery; medical cargo drone; health supply chain system. I. I ntroduction With the rise of the “humanitarian drone” in recent years, drones have become one of the most controversial public interest technologies [1]. Although using drones to deliver medicines in hard-to-reach areas has gained increasing media attention, routine drone delivery is still relatively new and largely unproven [2][3], Since 2016, Zipline has operated drones for the Government of Rwanda, delivering up to 3 liters of blood within 30 minutes to health facilities that request it on demand [4], In 2017, the Government of Malawi (GoM) established the Humanitarian Drone Testing Corridor (hereafter referred to as the Drone Corridor), in collaboration with a specialized UN agency, where studies on using drones to facilitate last mile delivery (LMD) and integrating drones in an optimized health supply chain system in low-resource settings, were implemented [5], In 2019, several other companies received approval to conduct routine flights or test deliveries, including transports of laboratory specimens in the USA by Matternet, and deliveries of over-the-counter medicines in Australia by Alphabet’s Wing [6][7]. It is worth noting that although there is a perception in the aid sector that drones hold the promise to reinvent the health supply logistics, to date, Zipline is the only example of routine drone delivery ofmedical supplies in an actual operational environment [8], The principle of public interest draws original inspiration from the concepts of newsworthiness and the public good [9], The tendency of framing technology as a panacea for the aid sector potentially leads to the technological fantasy, where “newness” and “newsworthiness” are hyped up while the public good and public interest de-prioritized [1][10], As the demand and complexity of aid programs in challenging conditions continue to expand, populations who live in remote locations experience significant obstacles to receive aid supplies, widening the gap of equitable access among the most vulnerable. These barriers give drones new purposes beyond their military origins, whereby they can be used to supplement the existing health supply chain systems to address the LMD challenge [11]. Since “do no harm” is not only about minimizing physical and material well-being, but as well maximizing the public good, one important evaluative criterion is whether the expected benefits of using drones to assist development work outweigh the potential risks over the long run [12][13]. This paper presents a recent field study conducted in Malawi during November 2019 and February 2020, where semi-structured qualitative interviews were carried out by the author (detailed research methods regarding data collection and analysis is documented in a forthcoming paper). In this study, drones were deployed to help address the medical supply delivery challenges in Malawi. The objective of the paper is to shed light, through a real-world case study, on risks and potential benefits of implementing such a systemic change from the ethical perspective. The paper is structured in three parts: 1) a medical delivery drone project operated in Malawi is introduced to set the context; 2) a general analysis of the field study is examined from the ethical perspective, whereby a noticeable mentality of “killing two birds with one stone” around the attempt of using drones to tackle health logistics challenges is observed, leading to the discussion that while the drone technology is portrayed as providing greater public good, its various limitations still await to be overcome through continued flight tests and feasibility studies; and 3) as conclusion, the author calls for a more reflexive approach in adopting new technology and implementing innovation policy in the aid sector. II. A Drone De l iv e r y Project A. Why Were Drones Proposed? Y is a government donor agency in the area of public health and international aid. By mandate, Y is involved with selecting, procuring, and delivering medications for infectious diseases, such as HIV/AIDS, as part of its global health initiatives, especially in countries in Africa, Asia and Latin America. It typically works in countries that are limited in resources in terms of personnel, finance, expertise, and infrastructure on the ground. In this context, it was perceived that the drone technology had unrealized potential to leapfrog poor infrastructure, and that there might be opportunities to use drones to provide uninterrupted supplies of health commodities, including drug delivery and lab sample collection and transportation. Y, therefore, decided to test if they could improve disease control using drones, and how they could undertake and manage drone operations in challenging environments. To this end, Y secured funding to 978-1-6654-1507-1/21/$31.00 ©2020 IEEE 339 Authorized licensed use limited to: MAIN LIBRARY UNIVERSITY OF ZURICH. Downloaded on June 29,2021 at 07:59:18 UTC from IEEE Xplore. Restrictions apply.