First they though; what the hell, let’s jump in. Let’s try it out, see where it goes. It can’t hurt.
That was in December 20023
Just six months later, they were already head over heels in love they just had to commit to it full time, with the eyes of God and hundreds of people as witnesses.
This January makes a full two years after the government of Eswatini launched the Nkwe Drone Network, which sought to ease the challenges of accessibility to medical supplies by people living in the remote part of the Southern African kingdom.
Before the drones were set free in these skies, the communities were underserved – with poor transport networks and medical facilities infrastructure, the delivery of vaccines, medicines, antivirals and emergency bloodwork samples remained constrained.
The situation only got worse during the rainy season when floods made most of these areas impassable.
Now, two years after the medical delivery drones were launched, Gavi is taking stock of how the network that made 600 flights in its first year is making progress in 2026 and beyond.
Gavi, the Vaccine Alliance, is a Geneva-based international public-private partnership established in 2000 to increase access to life-saving vaccines in the world's poorest countries.
It brings together governments, WHO, UNICEF, the World Bank, vaccine industry leaders, and foundations to vaccinate children against infectious diseases.
Below is the alliance’s report of how the drones have changes the healthcare landscape in Eswatini.
The name “Nkwe” means “sprint” in siSwati, and was conferred upon the unmanned fleet by the kingdom’s health minister, Mduduzi Matsebula, at the official launch ceremony in June 2024.
“[Using] drone deliveries instead of roads has really helped a lot of us as a clinic in the vaccination of kids, adults, treatments, HIV tests, urgent bloodwork,” said Lomalungelo Mavuso, a community health worker who has served at Ngculwini Nazarene Clinic since 2017.
Ngculwini is a rural healthcare centre in the Manzini Region in central Eswatini.
“A drone brings us the meds, right to our patients’ doorsteps,” she explains.
The driving force behind the drone initiative are The Luke Commission (TLC), a US-founded non-profit healthcare organisation operating in Eswatini for the last 20 years, and providing everything from cataract surgeries to HIV care.
In Eswatini, moving medications quickly and bring urgent medical care to people living in remote locations is problematic, says Lindani Sifundza, the TLC’s communications chief.
According to a 2020 study published in Human Resources for Health, Eswatini is in the league of 57 countries facing a “critical” deficit of professional health workers, with just 1.4 midwives, nurses and physicians per 1,000 population.
The situation is bleaker in rural districts, which tend to have both higher burdens of infectious disease and harder-to-navigate geographies. Sifundza adds that delays extend to the moving of diagnostic samples between remote clinics and laboratories in a kingdom with a centralised hospital infrastructure. This affects patient outcomes.
“So, we looked at what we can do to solve this problem,” he says.
The answer was in drones, which enable faster immunisation, quicker testing, treatment and fewer drug stockouts.
Nkwe’s long-range drone aircraft are manufactured by Kite Aero and can carry about four kilograms of medical payload, flying up to 200 kilometres on a single battery.
Health worker Mavuso says she has received vaccine consignments weighing 2.5 kg a mere nine minutes after sending a “simple, uncomplicated SMS” order.
At that range and speed, the entire 17,300km2 kingdom is reliably serviceable, and deliveries are typically six times faster than road transport, says Sifundza.
Achieving optimal impact demands collaboration, he adds. The Nkwe network relies on coordination between Eswatini Civil Aviation, the Health Ministry (who is the custodian of all vaccines made publicly available in the country), the police and the Transport Ministry.
“We are flying meds, vaccines, blood samples 400 ft above ground. In a rush to help patients, we must be mindful of traffic like helicopters,” he explains.
Whenever the Nkwe network onboards a new delivery site onto the network, a team from TLC go out to that site, and train clinic personnel on how to receive the drone, how to remove the goods out of the drone, and then how to launch the drone back to where it came from.
Drones enable that kind of helicopter-like speed to facilities on a routine basis at a much, much lower cost.
A typical day-to-day scenario involves rural nurses like Mavuso sending in SMS requests for vaccines, medications or sample pickup – for example, when a measles outbreak is confirmed in their service area, when blood drawn from a patient needs to be analysed in under 24 hours, or when a diabetic patient is critically ill and out of emergency insulin.
The request is then automatically displayed on Nkwe monitors, whose operation centre is embedded at a major hospital.
Nkwe drone pilots then initiate flights, tracking them on a digital database called Uvelo (“transparency”), minute by minute.
“It’s revolutionary,” says Mavuso of the drone flights. For those serving rural health centres like her, a car only comes once a week to carry blood samples, vaccines or other critical supplies.
Drone-based healthcare services have mushroomed around Africa in recent times – from Malawi to Mozambique, Nigeria, Ghana to Rwanda – carrying vaccines and other medical supplies.
But as Sifundza explains, what set the Nkwe network apart from the rest is that, while most of the drone networks on the continent are delivery-only – frequently dropping their parachuted payload before boomeranging back to base – the Nkwe network also lands at remote sites to pick up medical commodities.
“That’s one of the big differences,” Sifundza says.
“We are a two-way supply chain.”
There is now “a lot of demand” from people coming from nearby African countries to learn about the Nkwe drone initiative, wanting to replicate the success in their home countries, he says.
“We have a group of pilots that passed in the top one percent of their classes in South Africa, and that's just the tip of the iceberg (of our success),” he says.
The sustainability of flying around emergency vaccines, meds, blood and blood samples by drones in urban areas remains an important question. But for remote rural health centres, the benefits are unquestionable, he says – and the cost per flight compares well with alternatives.
Sifundza says an average motorbike delivery from a health centre to a remote location on the continent costs about $40–120. An offroad 4x4 vehicle costs $150–300. Helicopters are most expensive, costing upwards of $1,000.
“So, drones enable that kind of helicopter-like speed to facilities on a routine basis at a much, much lower cost,” Sifundza says.
The drones are safer too, he says. Getting something like measles or emergency rotavirus vaccines to very remote locations by road in Africa is not only labour-intensive, but also leaves the security of the cargo unassured.
Matsebula agrees.
“The Nkwe Drone Network helps Eswatini remove the traditional barriers in terms of healthcare,” he says.
“As more drone technologies evolve in the age of AI, the kingdom is already set to benefit,” he said at the public launch of the drone network last year.”