New technology for an old disease Unmanned Aerial Vehicles for tuberculosis sample transport in Papua New Guinea -- September 2014

Papua New Guinea 22 provinces Capital: Port Moresby/NCD Population: 7 million More than 800 ethnic groups 80% remote rural populations MSF presence: OCA & OCP OCP TB program in Gulf since May 2014

Tuberculosis burden Incidence - 346/100 000 Prevalence - 534/100 000 3rd cause of morbidity & mortality HIV/TB Coinfection:10% DRTB - 4.9% in new and 23% in retreatment Poor program outcomes > 50% PTB diagnosed without smear National success rate 69% (27% in Gulf) High defaulter rate: officially 19% but reported as high as 75%

Project set-up Close collaboration with NTP Central TB diagnostic and treatment centre Decentralized patient follow-up Average 50 patients enrolled /month 75% new cases 68% PTB 4% DRTB 25% under 15 years old Decentralised diagnosis and follow-up is the key to the success of

Challenges in Gulf Difficult access to remote health centers Biggest swamp in the world Only one road to go to the capital of the province Bad sea several months per year. Need to be innovative to bring diagnostic samples to MSF laboratory

Medical needs Medical-operational request: How to move Tuberculosis diagnostic samples from remote health centers to MSF laboratory in shortest possible time. Pre-requisite : System simple to use All season & Robust to face difficult weather conditions Safe and robust case to transport Tuberculosis samples

Matternet Profile American company based in California Already made a test in Haiti in 2012 UAV Electric system Up to 28km

UAVs trial

Results Papua New Guinea authorities supportive to the trial Feasibility test Test with a 500 gram load Good in wind up to 36 km/hour Good acceptance from the population But… Short range so far Need human action to swap batteries Still a product in development and not yet mature

Questions & future Is this technology too young to be reliable? Can we deploy it and if so can we scale it up? Can we afford it? Can we technically handle it internally or we will always need external support Will it be accepted in other countries? Where are we now? Contacts ongoing with other companies working on this technology Hopefully we will do another trial phase in 2015 More questions than answers

Acknowledgement Ministry of Health – Papua New Guinea Civil Aviation Authorities – Papua New Guinea Provincial Health Department – Gulf Province, Papua New Guinea For facilitating and authorizing this trial Matternet for binging technology and expertise OCP MSF team for organizing and coordinating this trial phase.