International Civil Aviation Organization PUBLIC HEALTH EMERGENCY PREPAREDNESS PLANNING IN THE AVIATION SECTOR: relevant ICAO SARPS AND USOAP Audit Protocol Questions 13 th Steering Committee Meeting of COSCAP-NA 16-18 April 2013 Jeju Island, ROK
Presentation Outline PHE Impact on air travel ICAO Health Related SARPs and Guidelines USOAP PHE Protocol Questions CAPSCA Asia Pacific Project Lessons from CAPSCA AVs Action by the meeting 2
Impact on air travel With a public health emergency of international concern (PHEIC) Not necessarily an infectious disease 3
People rushing out of an affected area Can anything be done at this juncture at the departure airport for departing passengers?
Full flights What measures can be implemented if a passenger falls ill?
Reflected in the arrival scene …coming away from an affected area Possibility of implementing measures at arrival airport?
….and then 7
Empty aircraft
Basis for Action - health Article 14, International Convention on Civil Aviation: …. and to that end contracting States will keep in close consultation with the agencies concerned with international regulations relating to sanitary measures applicable to aircraft.’
Basis for Action - health Article 14, International Convention on Civil Aviation: ‘Each contracting State agrees to take effective measures to prevent the spread by means of air navigation of cholera, typhus (epidemic), smallpox, yellow fever, plague, and such other communicable diseases as the contracting States shall from time to time decide to designate….
2003: SARS (Severe Acute Respiratory Syndrome) ISSUES: • Panic reactions • No preparedness plans • No Harmonization 11
2005 ----- H5N1 Avian Influenza WHO holds global meeting: Timing & severity of next pandemic cannot be predicted Take threat seriously Take appropriate actions & mobilize resources 12
H5N1 Start of Pandemic Spread to rest of world
H1N1 Start of Pandemic Spread to rest of world “Swine” flu There is no evidence of increased illness in the pig population
The Asia-Pacific region remains very sensitive to possible emergence of novel infectious agents
ICAO has been actively engaged with States and organizations International: WHO / ICAO / IATA / ACI / others Regional: Regional offices of WHO, ICAO etc Other Regional Organizations State level planning: usually led by Public Health PoE: CAA, Airport, Airlines, Public Health, other stakeholders 16
Harmonizing global aviation sector’s preparedness through CAPSCA (ICAO) Collaborative Arrangement for the Prevention and Management of public health events in Civil Aviation Asia Pacific 1. Implementation of ICAO Guidelines (State, Airport & Airline Guidelines) 2. Assistance visits to States and international airports 3. Training of personnel 4. Developing appropriate networks - public health authorities must work with civil aviation authorities, airlines, airport operators, air traffic control, customs and immigration and others. Launched Sept. 2006: Singapore
ICAO Health Related SARPs and Guidelines Annex 6 Annex 9 Annex 11 Annex 14 PANS -ATM
18 ICAO Annexes contain ‘SARPs’ (Standards and Recommended Practices) Annex 1 Personnel Licensing Annex 2 Rules of the Air Annex 3 Meteorological Service for International Air Navigation Annex 4 Aeronautical Charts Annex 5 Units of Measurement to be Used in Air and Ground Operations Annex 6 Operation of Aircraft * Annex 7 Aircraft Nationality and Registration Marks Annex 8 Airworthiness of Aircraft Annex 9 Facilitation * Annex 10 Aeronautical Telecommunications Annex 11 Air Traffic Services Procedures for Air Navigation Services – Air Traffic Management (PANS-ATM) * Annex 12 Search and Rescue Annex 13 Aircraft Accident and Incident Investigation Annex 14 Aerodromes * Annex 15 Aeronautical Information Services Annex 16 Environmental Protection Annex 17 Security: Safeguarding International Civil Aviation Against Acts of Unlawful Interference Annex 18 The Safe Transport of Dangerous Goods by Air Annex 19 Safety Management System
ICAO Health Related SARPs and Guidelines - Annex 6 Annex 6 – Operation of Aircraft On board medical supplies Inclusion of a universal precaution kit Managing on board communicable disease event Note: ** IATA Cabin crew procedures for managing travelers with a communicable disease - General Guidelines for Cabin Crew: SUSPECTED COMMUNICABLE DISEASE (October, 2011) 20
ICAO Health Related SARPs and Guidelines - Annex 9 Annex 9 - Facilitation provides for compliance with the pertinent provisions of the International Health Regulations (2005) of the World Health Organization (WHO) requires that the pilot-in-command of an aircraft shall ensure that a suspected communicable disease is reported promptly to air traffic control for onward timely notification to public health authority, in order to facilitate provision for the presence of any special medical personnel and equipment necessary for the management of public health risks on arrival at destination aerodrome requires a contracting State to establish a national aviation plan in preparation for an outbreak of a communicable disease posing a public health risk or public health emergency of international concern. The ICAO guidance in developing a national aviation plan or the ICAO “Template for a National Aviation Public Health Emergency Preparedness Plan” can be found on the ICAO CAPSCA website www.capsca.org . 21
International Health Regulations (2005) A global legal framework for public health security IHR (2005) came into force on 15 June 2007* Legally binding for the world’s countries that have agreed to follow the same rules to secure international health. 22
Purpose of the IHR (2005) “To prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade ” – Article 2 Courtesy WHO
ICAO Health Related SARPs and Guidelines - Annex 11 Annex 11 – Air Traffic Services and PANS-ATM Detailed procedure for utilising ATC for notifying destination of an on board public health event Public health emergencies included in contingency planning Doc 4444 PANS-ATM detail the procedures to be followed upon identification of a suspected case of communicable disease by the pilot-in-command in communication with air traffic control. Additionally it details the requirement for the ATS Unit to notify the associated Public Health Authority (PHA), aircraft operator and the aerodrome authority. 24
ICAO Health Related SARPs and Guidelines - Annex 14 Annex 14 – Aerodromes Public health emergencies included in aerodrome emergency plan 25
USOAP CMA Audit protocol questions undergoing final review To be implemented in May 2013 New questions on Public Health – crew procedure to evaluate travelers. – crew reporting procedures Amended questions on Public Health
USOAP CMA Audit – Organization / SAAQ Profile Page Protocol Guidance for review Status of Evidence/Notes/ ICAO ref. Reply question of protocol question implementation Comments ORG: prevention of communicable disease Yes Has the State CC Art 14 New question No identified a clear The World Health A9 8.12 & contact point at Organization’s national aviation 8.16 If yes, International Health level, with Regulations (IHR) A37-13 provide identified (2005) contain many name individual(s), for Articles of relevance to policy formulation, and aircraft and airport operational contact operators. The contact organization of details point addressed by this preparedness and question (or equivalent coordination of a individual in the national plan in regulatory authority) order to respond to should be aware of the a communicable existence of the IHR disease or other (2005) and should have public health a contact point in the emergency with State’s ministry of the potential to health to facilitate pose a serious intersectoral public health risk? collaboration
Organization protocols Has the State identified a clear contact point , with identified individual(s), at national aviation level for policy formulation, operational organization of preparedness and coordination of a national plan in order to respond to a communicable disease with the potential to pose a serious public health risk? CC Art 14; Annex 9, 8.12 & 8.16; A37-13
Aircraft Operations Protocols (1) Does the aircraft operations organization ensure that the air operator has established a procedure for the crew to evaluate a traveller with a suspected communicable disease , based on the presence of a fever and certain other signs or symptoms? Annex 9, 8.15, Note 1; Annex 6, 6.2 and Attachment B
International Civil Aviation Organization How does the crew know if they have a potential case of communicable disease on board?
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