Are Stem Cells The Future Of Medicine?

Physicians still have much to learn about how to more effectively utilize stem cells in their practice for the benefit of their patients.

In general, physicians and patients alike believe that stem cells are the future of medicine. According to Roger Pedersen, Professor of Regenerative Medicine and Director of the Anne McLaren Laboratory for Regenerative Medicine at the University of Cambridge, it is possible that stem cells will even be used to replace drugs (see “Stem Cells: The Future of Medicine?”[1]. However, Pederson points out that stem cells don’t fit the typical pharmaceutical business model, which is structured around putting medicines in people, “because [stem] cells are alive and can replicate inside the patient.” Consequently, according to Pederson, we may find that stem cells are even more powerful and flexible than we imagined.”

A Japanese researcher, Nobel laureate Shinya Yamanaka, collected genes from mature adult skin tissue and reprogrammed them to become “‘pluripotent,” which is a stem cell characteristic that means a cell is able to differentiate into multiple types of cells (see “iPS cells and reprogramming: turn any cell of the body into a stem cell,” Sept. 15, 2015,[2]. This conversion process, referred to as “induced pluripotent stem cells” (iPSCs), means that we can take adult cells from a person with a particular disease, turn them into iPSCs, and then induce the iPSCs to turn into different types of body cells. In commenting on Yamanaka’s iPSC findings, Pedersen says we can essentially “make any cell turn into any other type of cell and in effect move through wormholes in developmental time” to produce such things as a pancreas from skin tissue.” As a result, “the petri dish becomes an avatar of the patient” whereby medicines can be identified “that will improve the condition of cells in the patient without having to take cells out of the petri dish and put them back in the patient.”

Nevertheless, if the future of medicine is using stem cells to develop patient specific medicines or tissues in a laboratory then how can we benefit from using such stem cells in a clinical practice today? Currently, the two most common means for harvesting “stem cells” from a patient are by having a procedure done to obtain either blood from bone marrow or fat from liposuction. Both of these procedures are invasive and come with their own inherent risks. They each take anywhere from 1-2 hours to perform and require recovery time post-procedure. Unfortunately, neither of these procedures provides pluripotent stem cells, such as those needed for diverse tissue differentiation in a laboratory. Rather, these procedures produce mesenchymal cells, which work well for cardiovascular and orthopedic conditions because these tissues are the end organ targets for mesenchymal cells. However, they do not work well for other germ cell layer target organs, such as those produced from endoderm (incl., pancreas, liver, lungs) and ectoderm (incl., nervous system, skin).

Fortunately, there is a lesser known but more viable means for obtaining real pluripotent stem cells that merely involves a blood draw. In 2005, a study published in Minerva Biotechnologica identified stem cells in the blood (see “Adult-derived stem cells,”, Vol. 17, No. 2:55-63 (2005)[3]. In other follow-up studies, scientists showed that such cells could, in fact, be used to regenerate not only heart tissue, but brain, lung, and pancreas as well. What’s most interesting is that these cells were found to be increased when subjects ingested a blue-green algae product. This was initially demonstrated in a 2007 study where the level of pluripotent stem cells was shown to increase in equine blood after 6 hours from the initial dose (see “Totipotent Stem Cells are present in the Blood of Adult Equines,” Keystone Symposium (2007)[4]. These same stem cells were also found to be increased in the blood of humans by using the same algae product as used in horses.


In 2010, a clinical protocol was developed for harvesting, concentrating, reconstituting, and administering pluripotent stem cells obtained from autologous blood (see “Method of Stimulating and Extracting Non-embryonic Pluripotent Cells from Mammal Blood and Using Reconstituted Pluripotent Cells to Treat Disease Including Chronic Obstructive Pulmonary Disease,” Royal et al., USPTO Application Number 13362993 (2011)[5]. Initially, the protocol was used in the treatment of COPD patients because such cells could not only be given via intranasal, intravenous, intraspinal, and intravenous routes but nebulized as well. One of the initial COPD patients came from Houston, Texas where she was in a physical therapy group with 11 other COPD patients. Today, she is the only living survivor from the group and continues to receive a stem cell treatment biannually. While she still has COPD, the third leading cause of death in the United States that kills over 130,000 Americans annually, her oxygen saturation rates remain in the high 90’s.

It should be noted that in spite of the foregoing patient success, the use of stem cells for clinical applications is in its infancy. Physicians still have much to learn about how to more effectively utilize pluripotent stem cells in their practice for the benefit of their patients. Such knowledge includes not only using the most appropriate source for harvesting real stem cells but in improving the means of attracting those stem cells to where they are needed and facilitating their differentiation. As more physicians implement the use of pluripotent stem cells in their practice, such as those obtained from autologous blood, we can begin accumulating the objective data needed to validate stem cells in the present and advance stem cell science into the future.

by Daniel F. Royal, DO, HMD, JD
Turtle Healing Band Clinic, Las Vegas, NV

Body clock scientists win Nobel Prize



Three scientists who unravelled how our bodies tell time have won the 2017 Nobel Prize for physiology or medicine.

The body clock - or circadian rhythm - is the reason we want to sleep at night, but it also drives huge changes in behaviour and body function.

The US scientists Jeffrey Hall, Michael Rosbash and Michael Young will share the prize.

The Nobel prize committee said their findings had "vast implications for our health and wellbeing".

A clock ticks in nearly every cell of the human body, as well as in plants, animals and fungi.

Our mood, hormone levels, body temperature and metabolism all fluctuate in a daily rhythm.

Even our risk of a heart attack soars every morning as our body gets the engine running to start a new day.

The body clock so precisely controls our body to match day and night that disrupting it can have profound implications.

The ghastly experience of jet lag is caused by the body being out of sync with the world around it.

In the short term, body clock disruption affects memory formation, but in the long term it increases the risk of diseases, including type 2 diabetes, cancer and heart disease.

"If we screw that system up we have a big impact on our metabolism," said Prof Russell Foster, a body clock scientist at the University of Oxford.

He told the BBC he was "very delighted" that the US trio had won, saying they deserved the prize for being the first to explain how the system worked.

He added: "They have shown us how molecular clocks are built across all the animal kingdom."

The trio's breakthroughs were on fruit flies, but their findings explain how "molecular feedback loops" keep time in all animals.

Jeffrey Hall and Michael Rosbash isolated a section of DNA called the period gene, which had been implicated in the circadian rhythm.

The period gene contained instructions for making a protein called PER. As levels of PER increased, it turned off its own genetic instructions.

As a result, levels of the PER protein oscillate over a 24-hour cycle - rising during the night and falling during the day.

Michael Young discovered a gene called timeless and another one called doubletime. They both affect the stability of PER.

If PER is more stable then the clock ticks more slowly, if it is less stable then it runs too fast. The stability of PER is one reason some of us are morning larks and others are night owls.

Together, they had uncovered the workings of the molecular clock inside the fly's cells.

Dr Michael Hastings, who researches circadian timing at the MRC Laboratory of Molecular Biology, told the BBC: "Before this work in fruit flies we really didn't have any ideas of the genetic mechanism - body clocks were viewed as a black box on a par with astrology."

He said the award was a "fantastic" decision.

He added: "We encounter the body clock when we experience jet lag and we appreciate it's debilitating for a short time, but the real public health issue is rotational shift work - it's a constant state of jet lag."

Bill and Melinda Gates Grade the World’s Health

Bill and Melinda Gates speaking at their foundation headquarters in Manhattan last year. They will present a sort of report card of global health, called “Goalkeepers,” at the United Nations General Assembly this week. CreditSeth Wenig/Associated Press. 

Bill and Melinda Gates speaking at their foundation headquarters in Manhattan last year. They will present a sort of report card of global health, called “Goalkeepers,” at the United Nations General Assembly this week. CreditSeth Wenig/Associated Press. 

Bill and Melinda Gates handed the world a report card last week, assessing its progress on 18 global health indicators: infant mortality, AIDS, vaccine use, smoking rates and so on.

Called “Goalkeepers,” the report was a huge statistical effort, three years in the making, aimed squarely at the world leaders gathering at the United Nations General Assembly this month. To draw extra attention to it, the Gateses will hold an awards dinner and a public release this week featuring former President Obama.

In a series of recent interviews, they delivered several messages.

Progress has been great, but donor fatigue could be lethal to millions who could easily be saved. Only the United States is rich enough and generous enough to lead, and private charities, including theirs, cannot possibly coverthe deep cuts in global aid that President Trump has proposed.

Health journalists are sunk in negativism, they say, focusing on failures in a sea of global health successes.

In conversation, Mr. Gates displays such a deeply impressive grasp of the science fueling the discoveries he underwrites, and of the politics of the countries where they are deployed, that one forgets he was once a software geek.

At 61, he could speak with the avuncular magniloquence of a professor emeritus; instead, he layers on supporting data like a star pupil seeking an A-plus. He rebuts skeptical inquiries and insists on teaching from his own syllabus — and on flicking his own birch switch.

The report card will be issued annually, Mr. Gates said. He gave himself only a C+ on the first draft, promising sharper analytics in the future.

He isn’t actually handing out grades to the world’s health authorities — but is sending them home with a note for mom. Your kid has real potential but is becoming a discipline problem.

In some areas, like infant mortality, he considers the progress made “pretty miraculous.” In 1990, more than 11 million children died before their fifth birthday; now, fewer than 6 million do.

AIDS deaths have plummeted since 2004, and malaria deaths since 2005. Rates of childhood stunting, mothers dying in childbirth, and the miseries wrought by rare tropical diseases all have gone steadily down.

In poor countries, vaccine use is way up, though only about 75 percent of children get all the shots they need. More people have toilets these days.

Progress in other areas has been slower. Smoking is down, but tobacco companies are fighting back. Contraceptive availability is up, but almost half the women who want birth control still lack it.

Access to basic health care is up, according to the new report. But the gap between rich and poor countries remains vast, because too much money goes to top hospitals instead of rural clinics.

One key finding: Most of the progress was not bought by donors, but came organically as hundreds of millions of people scrambled out of the most abject tiers of penury.

In 1990, 35 percent of the world lived below the international poverty line (currently $1.90 a day); now, only 9 percent do. Most of the great leap upward was in just two economic powerhouses: China and India.

The report’s scarier themes lie in its projections for the next 15 years.

Assuming economic progress continues, improvements in most health categories will churn dutifully on, or at worst plateau. But since the 2008 economic crisis, donors have been losing their will to give.

If that persists, the report says, chaos threatens. H.I.V. infections could double, returning to levels not seen since the 1990s. And malaria could climb back to the peak hit in 2005.

H.I.V. and malaria are particularly vulnerable to fluctuations in funding because they are concentrated in Africa, where economic progress has been slower than in Asia or Latin America and where birthrates remain high, producing a big pool of potential victims each year. Malaria has a history of rebounding as soon as pressure is eased; both the mosquitoes and the parasites quickly evolve resistance genes.

The world’s birthrate is now peaking — probably forever — at about 134 million babies a year. “But it’s mind-blowing how much the shift in where kids are being born makes things hard for us,” Mr. Gates said.

Keeping infants alive gets tougher when they are born in lands with civil wars, dirt roads and healers who reject Western medicine.

Surprisingly, the new report was not a reaction to Mr. Trump’s threats to slash the foreign aid budget by 32 percent.

According to Dr. Christopher J.L. Murray, director of the University of Washington’s Institute for Health Metrics and Evaluation, which gathered the data, it was initiated three years ago because Mr. Gates feared the world was losing its focus on health.

“Goalkeepers” refers to a metric that the world ignores but the Gateses do not: the targets periodically set by the United Nations, namely the 2000 Millennium Development Goals and the 2015 Sustainable Development Goals.

The first sharply emphasized poverty and health. But the latter comprise 169 targets for everything from reducing overfishing to bringing clean energy and decent jobs for all — they have an “I-want-a-pony-too” air about them.

The world prefers simple goals, like declaring war on smallpox. But war talk has stung Mr. Gates. Calls for an “AIDS-free generation” – all the rage six years ago — were “premature,” he said, and he was “embarrassed” by claims that malaria could be eliminated by 2015.

He prefers “Microsoft-type thinking” to set realistic goals. “People expect a certain degree of honesty,” he said. “They want to know, do Bill and Melinda track this stuff?”

Essentially, he is tracking the world’s pursuit of his own goals as he helps it reach them.

In early interviews, Mr. Gates refrained from criticizing Mr. Trump but gave the clear impression that he believed Congress would ignore most of the president’s proposed cuts. Congress appears to be doing just that.

To hear Mr. Gates tell it, even the staunchest backers of an America First ideology, which he called “selfish,” succumb to his fusillades of data.

Before Stephen K. Bannon, the president’s chief strategist, resigned, Mr. Gates met him in the White House. “He said, ‘Africa has always been a mess,’” Mr. Gates said. “I went through the numbers on its progress with him. He was impressed.”

The new report’s weakness is that it cannot, for example, foretell how many more Ugandans would die of AIDS if American donations dropped 20 percent, in the way that the Congressional Budget Office can calculate how many Americans will lose insurance under a particular health care bill.

There are too many unpredictables in global health. A country would not just brutally take 20 percent of its H.I.V. patients off treatment, Mr. Gates noted. It might cut its military budget; it might try to stretch supplies of the drugs it got, triggering shortages.

Buried in the graphics-heavy report are some fun anecdotes that show how ingenuity can be just as important in the field as money.

In Ethiopia, for example, pregnant women were given a special stretcher to help them reach birth clinics; they had feared regular stretchers because villagers carried away on them usually died.

And an imam in Senegal described how he got other imams to accept birth control: by citing a saying from the Prophet Muhammad implying that children should be born about two years apart.


NHS checks 'should be done at shops and stadiums'



Vital health checks should be carried out in shops and at football grounds to diagnose people at risk of heart attacks and strokes, NHS chiefs say.

NHS England and Public Health England are urging the novel approach to get more people to come forward for the over-40s checks programme.

Only half of those eligible in England end up getting the regular checks.

Firefighters could even carry them out or refer patients while they do home safety checks, they say.

The health checks were introduced to spot the early signs of conditions such as dementia, diabetes, heart disease and strokes.

They look for conditions such as high blood pressure and cholesterol.

But because of the large numbers not taking part in the scheme, there are an estimated 5.5 million people with undiagnosed high blood pressure alone.

The health chiefs believe if everyone entitled to the checks, which are offered at least every five years up to the age of 74, got them, 9,000 heart attacks and 14,000 strokes could be prevented over the next three years.

The checks - organised by council public health teams - are normally done by GPs.

But a number of local authorities have started exploring new ways to carry them out.

In Cheshire, firefighters have been funded to start engaging people about their health and referring them on to services that can help.

In other areas, health staff have offered the checks in public places, including supermarkets, sports grounds and outside schools.

Dr Matt Kearney, from NHS England, said: "We know that much more can be done in communities across the country to prevent thousands of needless deaths each year due to strokes and heart attacks.

"Some parts across the country have already started to use non-traditional ways - and places - to carry out simple health checks, with encouraging results."

Duncan Selbie, chief executive of Public Health England, said he hoped it would lead to greater awareness about the risk of high blood pressure, the "invisible killer".

"We want people to be as familiar with their blood pressure numbers as they are with their credit card PIN or their height," he added.

Anxiety over health 'caused by cyber-chondria'

Cyber-chondriac? Looking up symptoms online is one way to create anxiety over your health. CREDIT: Getty Images

Cyber-chondriac? Looking up symptoms online is one way to create anxiety over your health. CREDIT: Getty Images

Worrying excessively about health, and going for unnecessary appointments and tests, is a growing problem - fuelled by looking up symptoms on the internet, researchers say.

Health anxiety can also be caused by previous health scares and could affect one in five hospital out-patients.

UK researchers said psychotherapy could reduce anxiety and should be on offer in all hospitals.

They are calling for official health anxiety guidelines to be drawn up.

A team including researchers from Imperial College London and King's College London said the symptoms of health anxiety were often mistaken for those of a physical illness and included chest pains and headaches that didn't go away.

Even when a doctor offered reassurance that there was no underlying physical reason for their symptoms, patients continued to worry and look for a diagnosis.

And this led to expensive and unnecessary medical appointments and investigations, as well as time off work, they said.

Prof Peter Tyrer, emeritus professor in community psychiatry at Imperial College London, said the internet had a part to play.

"We suspect that [health anxiety] is increasing in frequency because of what is now called 'cyber-chondria'.

"This is because people now go to their GPs with a whole list of things they've looked up on the internet, and the poor GP, five minutes into the consultation, has four pages of reading to do," he said.

"Dr Google is very informative, but he doesn't put things in the right proportion."

Prof Tyrer said patients didn't tend to pay attention to the word "rare" if they thought they had a disease.

The researchers, mostly mental health experts, said it was important to identify people with health anxiety and offer them treatment so their overall wellbeing improved.

They estimate that the problem could be costing the NHS at least £420m a year.

Useful therapy

In their study, published in the National Institute for Health Research journal, they found that cognitive behavioural therapy (CBT) sessions were much more effective at improving health anxiety than standard care, and the benefits lasted for up to five years.

They tracked 444 patients with severe health anxiety from five hospitals in England.

Nurses were just as good at delivering CBT as trained psychologists and doctors, the study suggested.

Prof Tyrer said official guidelines on how to treat health anxiety, from the National Institute for Health and Care Excellence (NICE), were "greatly overdue".

He said health anxiety was common in those with other physical illnesses, but was often ignored.

"So people, after apparently successful treatment of heart attacks, would interpret minor symptoms as warnings of further attacks, cut down on all their activities, create more suffering and have their lives thrown into chaos and disarray."

Mind and body

The researchers urged doctors to ask patients whether they were anxious about their health.

They said people were increasingly asked to monitor their own bodies for symptoms and diseases, and that was also fuelling health anxiety.

Prof John Chambers, consultant cardiologist at Guy's and St Thomas Hospital, said health anxiety caused repeated attendances in accident and emergency departments, GP surgeries and out-patient clinics and led to "over-investigation by clinicians".

He said they should consider a psychological explanation and a psychological intervention instead.

"These then need to take place locally and not at a site distant from the patient's presentation, so as to avoid the implied but unhelpful mind-body separation," he said.

NICE said its website featured guidance on general anxiety disorder (GAD) and panic disorder in adults that could be relevant.

It said NHS England had to refer specific topics to it before it could decide whether guidance was appropriate.

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'Pen' device can spot cancer in 10 seconds

The MasSpec Pen could replace the frozen section analysis method of finding cancerous tissue - which is slow and unreliable.

The MasSpec Pen can identify cancerous tissue in 10 seconds. CREDIT Pic: University of Texas

The MasSpec Pen can identify cancerous tissue in 10 seconds. CREDIT Pic: University of Texas


Scientists have invented a device the size of the pen which can detect cancer in a matter of seconds, aiding surgeons to remove "every last trace" of the disease.

The device is capable of identifying cancerous cells 150 times faster than conventional technologies and was 96% accurate in tests.

Researchers from the University of Texas say that the MasSpec Pen can help surgeons identify which tissue should be removed and which should be preserved, to help patients' recover.

Dr Livia Schiavinato Eberlin, who designed the study, said: "If you talk to cancer patients after surgery, one of the first things many will say is 'I hope the surgeon got all the cancer out'.

"It's just heartbreaking when that's not the case. But our technology could vastly improve the odds that surgeons really do remove every last trace of cancer during surgery."

The MasSpec Pen works by releasing a tiny droplet of water onto the target tissue, absorbing the chemicals inside of the cells.

This droplet is then analysed by an instrument called a mass spectrometer, which can analyse thousands of molecules, and quickly deliver the results to doctors on a computer screen.

Currently, distinguishing between cancerous and normal tissues involves a slow and unreliable process called frozen section analysis.

It can be risky because if a surgeon is unable to remove enough of the cancerous tissue it can allow tumours to regrow, but removing too much healthy tissue can also have detrimental effects.

These can be painful and could involve nerve damage in breast cancer patients, while thyroid patients could lose their abiltiy to speak.

James Suliburk, head of endocrine surgery at Baylor College of Medicine, said: "Any time we can offer the patient a more precise surgery, a quicker surgery or a safer surgery, that's something we want to do.

"This technology does all three. It allows us to be much more precise in what tissue we remove and what we leave behind."

The study has been published in the Science Translational Medicine journal, and the team hopes to start testing the device during surgeries next year.


Nurses' scrubs become contaminated with bacteria in hospitals Antimicrobial fabrics are ineffective for preventing transmission


Clothing worn by healthcare providers can become contaminated with bacteria, however having nurses wear scrubs with antimicrobial properties did not prevent this bacterial contamination from occurring, according to a study published online today in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.

As part of the Antimicrobial Scrub Contamination and Transmission (ASCOT) Trial, researchers from Duke University Hospital, followed 40 nurses who wore three different types of scrubs over three consecutive 12-hour shifts, taking a series of cultures from each nurses' clothing, patients, and the environment before and after each shift.

"Healthcare providers must understand that they can become contaminated by their patients and the environment near patients," said Deverick J. Anderson, MD, MPH, Director of the Center for Antimicrobial Stewardship and Infection Prevention at Duke University Medical Center and lead author of the study. "Although not effective, we looked to eliminate this risk for contamination by changing the material of nurses' scrubs."

In a random rotation, each nurse wore traditional cotton-polyester scrubs, scrubs that contained silver-alloy embedded in its fibers, or another type of scrub treated with a combination of antibacterial materials. The nurses did not know which scrubs they were wearing.

The researchers analyzed 2,919 cultures from bed rails, beds, and supply carts in each room and 2,185 cultures from the sleeve, abdomen and pocket of nurses' scrubs. No differences in contamination were found based on the type of scrubs worn.

Researchers identified new contamination during 33 percent, or 39 of 120 shifts. Scrubs became newly contaminated with bacteria during 16 percent, or 19 out of 120, shifts studied, including three cases of contamination of nurses' scrubs while caring for patients on contact precautions where patients were known to be infected with drug-resistant bacteria and personnel entering the room were required to put on gloves and gowns. The mostly commonly transmitted pathogen was Staphylococcus aureus including MRSA and methicillin susceptible S. aureus. The nurses in the study worked in medical and surgical intensive care units, caring for one to two patients per shift.

"There is no such thing as a sterile environment," said Anderson. "Bacteria and pathogens will always be in the environment. Hospitals need to create and use protocols for improved cleaning of the healthcare environment, and patients and family members should feel empowered to ask healthcare providers if they are doing everything they can to keep their loved one from being exposed to bacteria in the environment."

The authors note that the scrubs were likely ineffective at reducing pathogens because of the low-level disinfectant capabilities of the textiles, coupled with repeated exposure in a short timeframe. They suggest antimicrobial-impregnated textiles might be effective if used in bed linens and patient gowns, given the prolonged exposure to patients.

Given the findings, the authors recommend diligent hand hygiene following all patient room entries and exits and, when appropriate, use of gowns and gloves- even if no direct patient care is performed to reduce the risk of clothing contamination of healthcare providers.

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Tanzania Launches World’s Largest Drone Delivery Network

The Tanzanian government plans to launch the world’s largest drone delivery service to provide emergency on-demand access to life-saving medicines.


The Tanzanian government has announced its plans to launch the world’s largest drone delivery service to provide emergency on-demand access to critical and life-saving medicines by early next year.

The Tanzanian Ministry of Health and the country’s Medical Stores Department will work with California-based logistics company, Zipline, to open four distribution centres in the country over the next four years, with the intent to deliver blood using drones to over a thousand public health facilities in the country.

“Our vision is to have a healthy society with improved social well-being that will contribute effectively to personal and national development; working with Zipline will help make that vision a reality,” said Permanent Secretary of the Tanzania Ministry of Health, Dr Mpoki Ulisubisya.

“We strive to ensure that all 5,640 public health facilities have all the essential medicines, medical supplies and laboratory reagents they need, wherever they are—even in the most hard to reach areas,” added  Director General of Tanzania’s Medical Stores Department, Laurean Bwanakunu.

“But that mission can be a challenge during emergencies, times of unexpected demand, bad weather, or for small but critical orders. Using drones for just-in-time deliveries will allow us to provide health facilities with complete access to vital medical products no matter the circumstance,” continued Bwanakunu.

The drones and delivery service are built and operated by Zipline, which has been operating a blood delivery service in Rwanda since the launch in October 2016. Since last October, Zipline has flown more than 100,000 km in Rwanda, delivering 2,600 units of blood over 1,400 flights.

“Millions of people across the world die each year because they can’t get the medicine they need when they need it,” said CEO of Zipline, Keller Rinaudo.

“It’s a problem in both developed and developing countries. But it’s a problem we can help solve with on-demand drone delivery. And African nations are showing the world how it’s done,” continued Rinaudo.

Tanzania will make on-demand drone delivery of blood transfusion supplies, emergency vaccines, HIV medications, anti-malarials and critical medical supplies like sutures and IV tubes.

The first distribution centre, located in Dodoma, the country’s capital, will begin its first flights in the first quarter of 2018. Three additional distribution centres will follow —two in the north-western corner of Tanzania near Mwanza and Lake Victoria, and one in the Southern Highlands near Mbeya.

Each of the four distribution centres will be equipped with up to 30 drones and is capable of making up to 500 on-demand delivery flights a day. According to Zipline, the drones have capacity to carry 1.5 kilograms of cargo, cruising at 110 kilometres an hour, and have a round trip range of 160 kilometres.

Health workers place delivery orders by text message and receive their package within 30 minutes on average. Zipline’s drones take off and land at the distribution centre only, requiring no additional infrastructure at the clinics it serves. Deliveries happen from the sky, with the drone descending close to the ground and air dropping the medicine to a designated spot near the health centres.

For its Tanzania launch, Zipline says it will partner with the Human Development Innovation Fund, the Bill & Melinda Gates Foundation, and the Saving Lives at Birth initiative to conduct research on the Zipline’s impact on the region.