Reported by Ariajegbe Sylvia Esezobor
The Cross River State Government has called on Zipline, the drone-based medical delivery company, to reduce the cost of its services to enable the state to expand vaccine delivery to hard-to-reach communities, even as it acknowledged the significant impact of the initiative in reaching children who had previously received no routine immunisation.
The Director-General of the Cross River State Primary Healthcare Development Agency, Dr Vivien Otu, made the call on Wednesday during the close-out ceremony of the Zipline Zero-Dose Intensification Project in Calabar, marking the conclusion of an intervention that had deployed drones to transport vaccines to riverine and mountainous communities where poor roads and difficult terrain made conventional delivery nearly impossible. "Zipline is very good, but in Cross River State and all over, we keep telling them that the project is good, but it is very, very expensive," Otu said. "What Cross River State Government is asking is for them to reduce the cost of their implementation and services so that we will be able to afford them."
Otu said the state was in discussions with Zipline and its partners, including Gavi, Pfizer and UPS, on how to reduce the cost of the service to make it more affordable and sustainable. The discussions come as the state considers establishing a second Zipline hub to extend coverage to more parts of Cross River. The current hub serves nine local government areas, particularly communities in the central and northern parts of the state, but expansion depends on reaching an agreement on cost. "We need to settle on the cost first, before we think about creating another hub that will cover the remaining part of Cross River State," Otu said.
The Zero-Dose Intensification Project was designed to identify and immunise children who had not received the first dose of the pentavalent vaccine or other routine immunisation antigens, particularly those living in riverine settlements and other communities where poor roads and difficult terrain had made conventional vaccine delivery challenging. According to the state government, the project engaged more than 160 teams comprising vaccinators, recorders and mobilisers who were trained and deployed across the nine participating local government areas. Otu disclosed that the intervention had helped reach about 3.9 million children with vaccine doses, adding that some beneficiaries also received nutrition commodities and deworming services. "Some of these children are not just poorly vaccinated; they also have other challenges like malnutrition and lack of deworming. What Zipline does is that when we get these children, we give them all the packages that they have missed," she said.
The figures highlight the scale of the intervention, but they also underscore the challenge of reaching Nigeria's zero-dose children. According to Zipline Africa CEO Caitlin Burton, the partnership led to a 36 per cent reduction in zero-dose prevalence in Cross River State and a 42 per cent reduction in Bayelsa. These results reflect the growing recognition that drone delivery can bridge the gap in immunisation coverage for children who live beyond the reach of conventional health systems. The Commissioner for Health, Henry Ayuk, said the use of drones had significantly improved healthcare delivery, enhancing efficiency and responsiveness in the distribution of medical supplies to health facilities across diverse and challenging terrains. "Beyond faster deliveries to hard-to-reach areas, the system has reduced wastage and helped curb the circulation of counterfeit medicines, thereby strengthening the integrity and reliability of the state's drug supply chain," Ayuk said.
Zipline's Commercial Director, Hanatu Adeboyega, said the company had been operating in Cross River since 2023 and had delivered more than 13 million vaccines and other medical commodities through its logistics system. Adeboyega said the company was interested in sustaining and expanding its partnership with the state government, noting that its services also covered essential medicines, storage, logistics and data collection. She described Cross River's terrain as challenging, particularly in communities where flooding, poor roads and waterways often prevented residents from accessing health facilities, and said the drone delivery system had helped bridge the gap by taking vaccines and other medical supplies to agreed locations in difficult-to-reach communities.
The cost concerns raised by Cross River reflect a broader challenge for drone delivery programmes in Nigeria. While the technology has proven effective in reaching remote communities, the financial sustainability of these operations remains a critical question for state governments with limited resources. Cross River is the second state in Nigeria, after Kaduna, to adopt drone technology for vaccine delivery, and the state has also partnered with Blackfrog Technologies Limited, an Indian company specialising in medical-grade refrigeration systems, to strengthen its cold chain. The state has committed to achieving universal health coverage by 2030, and drone delivery is a central component of that strategy.
Zipline, which expanded to Nigeria in 2022, operates three hubs in Kaduna, Cross River and Bayelsa, serving more than 1,300 health facilities and about six million people. The company plans to expand to 15 distribution centres across Nigeria by 2028, extending its reach to nearly 20,000 health facilities and serving close to 100 million Nigerians. The expansion targets rural and remote communities facing chronic shortages of vaccines, blood products, malaria medication, anti-venom and maternal healthcare supplies. Its distribution centres in Kaduna and Cross River run fully on solar with backup energy redundancy, a critical feature in a country where grid reliability is a daily operational risk.
The political context of the cost discussions is significant. The 2027 general elections are less than four months away, and healthcare delivery remains a central concern for voters in Cross River and across the country. Governor Bassey Otu's administration has invested in healthcare infrastructure, upgrading more than 100 primary healthcare centres across the state's 18 local government areas and designating facilities specifically for the elderly, children under five and pregnant women. The drone programme has strengthened the state's immunisation record, with Cross River among the top-performing states in vaccine coverage. But the financial burden of sustaining the service poses a dilemma for a state that must balance its health priorities against competing demands on its budget.
For the children who have received vaccines through the drone programme, the intervention has been life-changing. For their families, it has removed a critical barrier to preventive care. For the state government, the challenge is to ensure that the gains recorded are not reversed because of cost constraints. As Otu put it, the project is good, but it is very expensive, and the state is asking Zipline and its partners to reduce the cost so that it can be sustained. The coming months will determine whether an agreement can be reached and whether Cross River can establish a second hub that brings the benefits of drone delivery to more of its remote communities.
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