Scaling Autonomous Solutions: An Interview with CEO of Zipline, Keller Rinaudo Cliffton

Keller Rinaudo Cliffton, Harvard '09, is the CEO of Zipline, a global logistics company pioneering autonomous drone delivery for medical and commercial supplies.

Zipline began its first logistics operations in Rwanda, delivering life-saving blood supplies to local hospitals. You’ve mentioned before that you chose this partnership because you needed a country as agile and entrepreneurial as your company. Could you tell us more about the dynamics of this partnership? What lessons have you learned in Rwanda that later helped you grow in the rest of Africa?

When we started building the technology, we saw a huge opportunity to create the first logistics system that would serve all people equally. We wanted to enable universal access to healthcare and create economic opportunities for people around the world.

When I went to Rwanda and met with the Minister of Health, I shared this broad vision: we’d deliver medical products to every hospital in the country using autonomous aircraft and transform the health system. I remember she looked at me and said something along the lines of, “Keller, shut up. Just do blood.”

That was powerful advice. She explained that approximately 50 percent of transfusions go to mothers with postpartum hemorrhaging and 30 percent go to children.  Blood is an incredibly difficult product to deliver at the right time and place due to its different components—packed red blood cells, platelets, plasma, and cryoprecipitates—each of which comes in different blood types: A, B, AB, and O, including positive and negative types, and more. Just getting the right type to the right place is a logistical nightmare.

They made that bet on us. We signed an initial contract to deliver blood to 21 hospitals across the country. Looking back, it was a crazy thing for them to trust us and for us to think we could pull it off. But we did. Zipline delivered to all 21 hospitals and became core infrastructure for those facilities. Then, we expanded to 50 hospitals, and after that, 100 hospitals. Today, we serve more than 700 hospitals and health facilities across Rwanda.

Globally, we now serve almost 5,000 hospitals and health facilities across eight countries.

It took a lot of vision from the Rwandan government.

We went from delivering just blood to delivering all medical products, then animal healthcare supplies, and even artificial insemination products for cattle and pigs. Then, we introduced childhood malnutrition treatments. Now, we’re delivering e-commerce products nationwide. What’s amazing is that even eight years later, the system is still growing fast. In 2024 alone, our Africa business doubled in scale.The country is even discussing building a new national postal service using Zipline’s infrastructure.

Zipline was critical to the pandemic response in Ghana and Rwanda, delivering over 1 million vaccines to fight against the virus. Could you tell us more about how your company was able to react and adapt effectively to such a shock?

When the pandemic hit, we approached things in a pretty unique way.

First, we did not send people home, despite the general stay-at-home orders. Zipline is a healthcare company, and tens of millions of people depend on us every day. Those people were more desperate than ever because many human-based logistics systems were shutting down.

A ton of inventory in the system began to flow into Zipline. For example, within just two weeks at the start of the pandemic, the number of vaccines we were delivering increased tenfold. We saw this huge surge in demand, and we had to make sure our teams kept coming in. We spread out our desks in the Aviary to keep people safe, because we were building aircraft—you can’t exactly build scalable hardware from your bedroom.

At the same time, we were working to maintain the global supply chain to respond to this unprecedented increase in demand.

Interestingly, a lot of medical products started flowing into Zipline’s infrastructure for the first time during the pandemic. Even after people went back to work, those products never left. It was like they had found a better way of moving.

To this day, Zipline still delivers all those vaccines, cancer therapies, and other public health supplies. Once they were being delivered in this faster, more efficient way, it just did not make sense to revert to the older, less reliable system of humans driving trucks.

In its initial launch period, Zipline has experienced many challenges, from failure to launch to retrieval errors. You are known for your entrepreneurial optimism and resilience, but how do you, as a leader, guide a team through failure? Tell us more about your leadership style.

When I was an undergraduate at Harvard, I built a climbing wall there. Climbing has always been a huge part of my life. After graduating, I spent a year and a half as a professional climber before starting Zipline.

Professional climbing is interesting. There was one route I had been trying to complete throughout college—it's called China Beach, located in Rumney, New Hampshire. I first attempted it as a freshman and drove up every weekend from my dorm. A graduate student who had a BMW would lend me the car, and I'd make the trip up to try the climb.

The thing about climbing at that level is that you spend every weekend failing. You try the route, you fail over and over again. You're learning the technique, figuring out sequences, building strength. But 99.9 percent of the time you fail. Then, a week before I graduated, I finally completed it. It took four minutes to climb from bottom to top cleanly. It felt amazing, but the high lasted only a couple of hours before I was already thinking about the next project, the next difficult route I’d probably fail on another hundred times.

Rock climbing naturally prepares you for entrepreneurship. It gets you used to failing a lot. Unfortunately, the best schools in the U.S. often teach the opposite. I speak to Harvard or Stanford students sometimes, and I always emphasize this: to get into those schools, you basically have to go through life without failing. But entrepreneurship demands the opposite. You have to be willing to fall flat on your face 50 times. You get humiliated. Everyone around you has great jobs in consulting or investment banking, making more money, while you're off doing something weird that looks like a waste of time.

At Zipline, we try to do ten new things a day, and nine of them fail. From the inside, it often feels like a mess. But from the outside, investors look at Zipline and say, “This is a company that seems to have a breakthrough every day.” They see an incredible rate of progress.

And that’s the disconnect. Once you leave school, no one knows when you fail, and no one cares. You can fall on your face as many times as you want. People only notice when you succeed. School teaches you that failure is unacceptable, but in the real world, progress and innovation depend on it.

Zipline has taken enormous strides in making healthcare delivery accessible to the underserved. Though many NGOs or governments have aspired to achieve the same - their efforts are not always successful. In your experience, what is the benefit of public-private partnerships, and the role of start-ups in creating such global impact?

Global public healthcare has, for nearly a century, been dominated almost entirely by nonprofit organizations. There’s been a lot of good work done, but over the past 10 to 20 years, there’s also been a huge amount of inefficiency, bureaucracy, and waste. Ironically, many of these programs have names that sound unimpeachable—like “Reduce Childhood Cancer Mortality Foundation.” You hear that and think, “Who could be against it?” But then you look into the numbers and realize 85 percent of the budget goes to overhead, with only 15 percent reaching actual children with cancer.

If you really want to understand how the U.S. can play a constructive role in the world, the best way is to ask countries what they want.

In global aid, particularly in Africa, where NGOs dominate, these countries have been saying for decades: We want trade, not aid. Leaders like Paul Kagame, the President of Rwanda, have been crystal clear: they don’t want low-quality, free services that undermine local economies. They want innovation, entrepreneurship, job creation, and foreign direct investment.

I think we should listen.

It’s honestly crazy. In the U.S., nearly every industry is being transformed by technology—AI, automation, and robotics. When it comes to global public healthcare? It’s stuck decades in the past. It still relies on outdated technology, bloated administrative costs, and extremely low impact per dollar spent.

We need more competition. Governments, especially the U.S. government, should be paying for results, not actions. That shift is already beginning, and I think it's going to redefine global public health over the next decade. Taxpayers are demanding real outcomes for their money, and that’s going to push governments to open up markets and invite private companies to compete.

When that happens, private companies can often deliver better results, at far lower cost, by leveraging technology and innovation. That’s what countries actually want. And when those companies also create high-paying, sustainable jobs in those countries, they contribute directly to the long-term economic growth and independence that those nations are asking for.

In countries where Zipline has become public infrastructure, what have you learned about the responsibility of private companies when they start to take on public functions?

The simplest answer is: let market forces work.

If the U.S. government or an NGO wants to vaccinate a million kids, the traditional approach is to build an entire nonprofit organization from scratch. First, they hire an executive staff, then a huge team of consultants, usually based in Washington, D.C. They contract with firms like JSI and Chemonics, known as the “beltway bandits,” forming what’s often called the donor industrial complex.

Then they fly consultants business class back and forth to Africa for years to do project plans and program management. Eventually, they build a bespoke nonprofit-run supply chain just for that specific vertical—say, vaccines or antimalarials. If that sounds crazy, that’s because it is crazy. Yet, it’s exactly how the system works today.

A better way is obvious: decide the goal—vaccinating one million kids—and solicit ten bids. Five from NGOs, five from private companies. Choose the most cost-effective and credible proposal, and structure payment based on results. That’s it. Let the free market work. It’s an incredible force that brings innovation, efficiency, and entrepreneurship to the world’s most important problems.

It’s frankly wild that we have Instagram for pets—whole ecosystems of innovation for trivial problems. But when it comes to vaccinating 100 million children every year, there’s no private sector, no market competition, no real technology. That’s insane.

We need to let markets work. Large institutions like USAID, the Global Fund, and GAVI should focus on paying for results, not actions. They must open up to private sector competition. That’s what’s needed to drive efficiency and unlock real impact.

Just like the U.S. needed a SpaceX to break through the NASA cabal, we need a new model for global aid. If the U.S. wants to project power and influence in a more modern, effective way, we think that’s a great thing. But it has to happen by empowering innovation, competition, and market-driven results.

Cliffton spoke with Sheth on May 7, 2025. This interview has been lightly edited for length and clarity.

The views expressed in this piece are the interviewee’s own and are not reflective of the views of the HIR.