The technology could reduce the time it takes to get an HIV diagnosis from months to days.
There was a mixed reaction from bystanders as the object slowly hovered back down to earth, kicking up small columns of dust as it landed. We were standing outside a health clinic in Malawi's capital, Lilongwe, watching the inaugural launch of a small white drone. Malawian officials said a prayer to bless its virgin flight, and they issued assurances that it was not powered by witchcraft. Some spectators cheered; others, afraid the drone might land on them, took shade next to tall maize plants, shielding their heads.
"I'm glad I know what it is," said Scholastic Billiard, who like many of the other women gathered at the clinic, was pregnant. "I would have thought it was a bomb coming to be delivered, or the start of a war." Instead, the custom-made drone is part of a UNICEF pilot program to fly around and deliver HIV tests and results.
Malawi has one of the highest rates of HIV in the world, with roughly 15 percent of adults carrying the virus. An estimated 170,000 children in the country are also HIV-positive, and young people between the ages of 15 and 18 account for half of new HIV infections. The death toll is tremendous—33,000 people in Malawi died of AIDS complications in 2014 alone, including 10,000 children, according to UNAIDS—in part because many people are undiagnosed or lack access to antiretroviral drugs.
"It's a good idea, as people will get their [HIV test] results faster," Billiard said of the drone, adding that she knows adults who have had to walk miles to access tests, and then wait weeks, or even months, to find out the results.
While adult blood tests are relatively simple, diagnosing babies is a more complex and lengthy process, requiring DNA samples to be sent from rural clinics to one of the eight laboratories in Malawi that perform the test. According to clinic workers here, some HIV-positive mothers have to wait months to find out if their babies have the virus, often walking more than two hours for the results only to find out that a driver has again failed to deliver them. After a couple of attempts, clinic workers said, some just give up. For a virus that kills around one third of infected babies before age one, and half before age two, delayed test results and treatment with antiretrovirals can be a matter of life or death.
"Imagine if you were a mother, and you had to wait six months to know whether your child is HIV-positive or not? It would be terrifying," said Mahimbo Mdoe, UNICEF's representative in Malawi. Mdoe hopes that the drones can slash transport costs related to test delivery by "at least half."
"Necessity is the mother of all inventions," Mdoe said. "And at the moment, Malawi is doing that."
At the clinic in Lilongwe, a nurse named Gift Dombolo smiled as she watched the drone create orange dust devils in the courtyard, following its path with her smartphone camera. The drone is still in testing, but if it all goes well, a fleet of drones will be able to carry about 250 tests each to different drop-off points.
For clinic workers like Dombolo, it would mean replacing the flawed testing and delivery system with the touch of a button."The problem of fuel and the problem of traffic, it [the drone] has beaten them all," she said.
But Dombolo also worries that the hovering machines could be met with superstition. In Malawi–a country where three quarters of the population believes in witchcraft, and where those accused of the practice are aggressively prosecuted—a drone landing in someone's garden could easily be read as "witchcraft or something satanic," she said.
According to a September report from the Malawi News Agency, there was quite a stir in Kasangu after a man spotted an alleged "witchcraft plane" crashing outside a home in the early hours of the morning. The claim prompted debate over whether or not the object was proof of witchcraft, and hundreds of people gathered at local police stations hoping to glimpse the black tube with two sticks.
"They will have to know what is flying on top of them, as now they will have that fear," said Daniel Nyerenda, a health officer at another mother-and-child HIV clinic in Malawi. The clinic where he works treats more than 350 patients, up from just seven in 2010, he said, and some of his patients have stopped making the hours-long walk to the clinic to pick up their antiretroviral drugs—a problem that UNICEF's drone program could remedy.
To dispel witchcraft rumors surrounding the new HIV drones, UNICEF has been carrying out drone awareness campaigns in Malawi. Jim O' Sullivan, a pilot-turned-drone technician who works for Matternet, the California-based company that created the specialty HIV-testing drones, says that in communities included in the public education campaign, the reaction has been "heartwarming."
"The kids love it," he said. "When they see the vehicle take off, they will often times cheer. We haven't noticed any fear of it."
Follow Hannah McNeish on Twitter.