ICAO and Public Health Emergencies Meetings Seminars...addresses public health emergencies of...
Transcript of ICAO and Public Health Emergencies Meetings Seminars...addresses public health emergencies of...
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International Civil Aviation Organization
ICAO and Public Health Emergencies
Dr. Anthony Evans
Chief, Aviation Medicine Section
ICAO, Montreal
Frankfurt, July 2012
Acknowledgement
• Mr Michiel Vreedenburgh
– ICAO Deputy Regional Director (Mexico Office) & CAPSCA project coordinator
– Provided some images for this presentation
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Plan
• Background to ICAO
• Aviation–related health issues
• Multi‐sector preparedness
• Way forward – high level
• Way forward – technical level
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ICAO – UN specialized agency created in 1944. Strategic Objectives:
• Safety • Security • Environmental protection
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Mexico
Lima
Dakar
Paris
Cairo
NairobiBangkok
ICAO HQMontreal
International Civil Aviation Organization ‐HQ and its seven Regional Offices
Why worry about aviation?
• Medical health– Spread of disease by travellers– Other issues:
• Transport of samples – e.g. biological/radioactive
• Transport of vectors• Transport of personnel to/from affected areas
– Risk to individuals on aircraft
• Economic health– Airlines– Supporting businesses– Governments
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Some aviation health‐related issues
Bennett, JS – NIOSH, 2009
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Some aviation economic‐related issues
Passengers of Hong Kong International Airport, January to August 2003
0
500
1000
1500
2000
2500
3000
3500
Jan Feb Mar Apr May Jun Jul Aug
Month
No.
of
pass
enge
rs (
' 000
)
Courtesy: Dr Henry Kong, past Chief Port Health Officer, Hong Kong
12 March, WHO Atypical pneumonia alert
2 AprilWHO traveladvisory
23 MayTravel advisory lifted
International arrivals, Mexico, 2008‐2010Courtesy: Dr Jose Valente Aguilar Zinser, Ministry of
Transport, Mexico
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Challenges• Aviation is:
– Focused primarily on prevention of accidents– Personnel not generally knowledgeable about public health
• Public health is:– Focused primarily on non‐transport related health issues – Personnel not generally knowledgeable about aviation
• And so…..
• Preparedness planning in aviation can fall between two stools.
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One answer:
• Multi‐sector preparedness planning– WHO/public health cannot alone provide necessary resources
– Many sectors involved to varying degrees
– Private industry involvement vital
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Interlinking guidelines
WHO global Preparedness
ICAOStandards & Guidelines
for aviation
Airports Council International:
airport guidelines
International Air Transport Association:
airline guidelines
IHR 2005
Guide to Hygiene and Sanitation in Aviation
Case managementof Influenza A(H1N1) in air transport
www.capsca.org
Multi‐sector involvement:A challenge to achieve
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Fukushima nuclear accident:ICAO Transport Task Force
Weekly teleconference call
ICAOIAEAWHOIMOWMOUNWTOILO
IATAACI
ICAO – International Civil Aviation OrganizationIAEA – International Atomic Energy AgencyWHO – World Health OrganizationIMO – International Maritime OrganizationWMO – World Meteorological OrganizationUNWTO – UN World Tourism OrganizationILO – International Labour Organization
IATA – International Air Transport AssociationACI – Airports Council International
Output ‐ Three News releases during the initial weeks
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Way forward – high level
• High level management buy‐in
– Role of UN
• Resources allocated to multi‐sector collaboration
• Combined agendas
• Public and private involvement
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Way forward – technical level: CAPSCA(Cooperative Arrangement for the Prevention of Spread of Communicable Disease through Air Travel)
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CAPSCA programme implementation
• Meetings– Annual regionalmeeting e.g. this meeting in Frankfurt
• Update in preparedness planning in the aviation sector
• Multi‐sector communication/networking platform
– Annual globalmeeting, regional meeting is designated ‘global’ • On rotation: 2010, Asia Pacific; 2011, Africa; 2012, Americas; 2013, Middle East; 2014, Europe
• Assistance Visits– To individual States/airports
– Assist with implementation of • ICAO health‐related Standards and Recommended Practices (SARPs)
• WHO International Health Regulations
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CAPSCA Resources
• Donors – UN Central Fund for Influenza Action ($1.3 m for all five projects – Asia Pacific; Africa; Americas; Europe; Middle East)– CAA Singapore (Dr Jarnail Singh, technical advisor)
• Partners: Principal International Organization partner – WHO
• Member States’ Technical Advisors
• Meeting Hosts (ICAO Regional Offices and States)
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Asia‐Pacific Africa Americas Europe Middle East
Year of Establishment
2006 2007 2009 Sept. 2011 Dec. 2011
No. MemberStates
17 17 30 6 7
State Technical Advisors Trained by ICAO (OJT completed)
1 4 12 0 2
State & Airport AssistanceVisits Completed
9 5 22 0 2
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Aims of this meeting
• Update on preparedness planning in aviation• Networking ‐multi‐sector, public and private• Select a CAPSCA‐Europe chair (normally three year term)• Encourage more States to join CAPSCA
– No cost
• Identify States/Airports for Assistant Visits– Intention, no cost: may not be possible (CFIA grant ends
December 2012, & funds are low)
• Identify CAPSCA‐Europe Technical Advisors (TAs)• Commence TA training (presentation from Frankfurt Airport
and walkthrough/debrief)• Identify host for 2013 CAPSCA‐Europe meeting
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ICAO and Public Health Emergencies
Dr. Anthony [email protected]
Chief, Aviation Medicine SectionInternational Civil Aviation Organization
Frankfurt, Germany, July 2012
Fukushima Daiichi Nuclear Power Plant11 March 2011
CAPSCA‐Frankfurt July 2012
What if:•An aircraft flies through the plume?•An aircraft is parked overnight downwind?•An exposed individual wants to fly for treatment?
Screening:•Should Japan be screening departures?
Cargo?People?
•Should other countries be screening for arrivals?Cargo?People?
•What levels are acceptable?•What equipment/training/PPE is needed?•Etc….
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ICAO Transport Task Force
Weekly teleconference call
ICAOIAEAWHOIMOWMOUNWTOILO
IATAACI
ICAO – International Civil Aviation OrganizationIAEA – International Atomic Energy AgencyWHO – World Health OrganizationIMO – International Maritime OrganizationWMO – World Meteorological OrganizationUNWTO – UN World Tourism OrganizationILO – International Labour Organization
IATA – International Air Transport AssociationACI – Airports Council International
Output ‐ Three News releases during the initial weeks
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Plan
• ICAO – International Civil Aviation Organization
• Convention on International Civil Aviation ‐(‘Chicago Convention’) and its Annexes
• Standards and Recommended Practices
• ICAO Guidelines on Public Health Emergencies
• ICAO Assembly Resolutions
• ICAO Audits
• UN crisis management
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ICAO HQ – Montreal, Canada
18 Annexes to the Convention ‐‘Standards and Recommended Practices’ SARPs
•Governments
Regulatory Aviation Authorities
e.g.
•Federal Aviation
Administration (US)
•Transport Canada
•UK CAA
96 Articles
‘Chicago’ Convention (1944) – 191 signatories
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Basis for Action ‐ health
Article 14, Convention on International 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….
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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.’
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18 ICAO Annexes to the Convention‐ contain ‘SARPs’
• 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
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ICAO Standards are audited:Results posted on ICAO public website
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International Passengers to Mexico, 2009‐2011 (25 April WHO announced PHEIC)
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International Arrivals
Passengers of Hong Kong International Airport, January to August 2003
0
500
1000
1500
2000
2500
3000
3500
Jan Feb Mar Apr May Jun Jul Aug
Month
No.
of
pass
enge
rs (
' 000
)
Courtesy: Dr Henry Kong, past Chief Port Health Officer, Hong Kong
12 March, WHO Atypical pneumonia alert
2 AprilWHO traveladvisory
23 MayTravel advisory lifted
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Fukushima nuclear powerplantaccident – 11 March 2011
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Fukushima Daiichi Nuclear Power Plant11 March 2011
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What if:•An aircraft flies through the plume?•An aircraft is parked overnight downwind?•An exposed individual wants to fly for treatment?
Screening:•Should Japan be screening departures?
Cargo?People?
•Should other countries be screening for arrivals?Cargo?People?
•What levels are acceptable?•What equipment/training/PPE is needed?•Etc….
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How does it work in practice?
• An example –
– determination of a case of communicable disease on board an aircraft in flight
– notification to the public health authority at destination
– further communication with the aircraft
– how to manage the aircraft’s arrival at destination
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PHA
AIRPORTOPERATOR OTHER
AGENCY
NOTIFICATION OF EVENT TO DESTINATION AIRPORT
Air traffic controller
AIRLINE OPERATING AGENCY
Destination aerodrome tower
A/C IDDep.Dest.ETAPOBNo. casesNature of risk
Aircraft gen. declaration –Health Part (WHO & ICAO docs)
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GUIDELINES ‐ assist with interpretation of ICAO SARPs
and the IHR (2005)
To help States develop and implement national
preparedness plans we have “CAPSCA”
Cooperative Arrangement for the Prevention of Spread of
Communicable Disease through Air Travel
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ICAO Assembly ResolutionsSeptember/October 2010
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And nowCAPSCA!
CAPSCA WP Resolution
The Assembly:
1. Urges Contracting States and Regional Safety Oversight Organizations to ensure that the public health sector and the aviation sector collaborate to develop a national preparedness plan for aviation which addresses public health emergencies of international concern and which is integrated with the general national preparedness plan;
2. Urges Contracting States to develop a national preparedness plan for aviation that is in compliance with the World Health Organization International Health Regulations (2005) and which are based on scientific principles and on the guidelines from ICAO and the World Health Organization;
3. Urges Contracting States, and Regional Safety Oversight Organizations as appropriate, to establish requirements for the involvement of stakeholders such as airport operators, aircraft operators and air navigation service providers in the development of a national preparedness plan for aviation; and,
4. Urges Contracting States to join and participate in the Cooperative Arrangement for the Prevention of Spread of Communicable Disease through Air Travel (CAPSCA) project, where available, to ensure that its goals are achieved, unless equivalent measures are already in place.
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To ensure States implement the ICAO SARPs ICAO auditscivil aviation regulatory
authorities
UN Humanitarian Response to crises
• The Cluster System– Camp Coordination– Early Recovery– Education– Emergency Telecommunications– Food Security– Health
– Logistics – transport cell proposed– Nutrition– Protection– Water and Sanitation
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Summary
• ICAO and Convention on International Civil Aviation ‐ (‘Chicago Convention’) and its Annexes
• Standards and Recommended Practices within the Annexes
• Guidelines on Public Health Emergencies• CAPSCA – implementing project• ICAO Assembly Resolution• ICAO Audits• UN crisis management ICAO
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ICAO and Public Health Emergencies
Dr. Anthony EvansChief, Aviation Medicine Section
International Civil Aviation Organization
Cairo, December 2011
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CAPSCA: A37‐WP/58 Technical Commission
Agenda Item 42: (Cooperative Arrangement for the Prevention of Spread of Communicable Disease through Air Travel (CAPSCA))
WP/58 Title:
Improved management of communicable disease in the aviation sector through multi‐sector collaboration
Result: Resolution 42/1: Prevention of spread of communicable disease through air travel
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CAPSCA Resolution
Resolution 42/1: Prevention of spread of communicable disease through air travel
Whereas Article 14 of the Convention on International Civil Aviation states that ‘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, 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’;
Whereas Article 14(1) of the World Health Organization International Health Regulations (2005) states that ‘WHO shall cooperate and coordinate its activities, as appropriate, with other competent intergovernmental organizations or international bodies in the implementation of these Regulations, including through the conclusion of agreements and other similar arrangements’;
Whereas ICAO Resolution A35‐12 states that ‘the protection of the health of passengers and crews on international flights is an integral element of safe air travel and that conditions should be in place to ensure its preservation in a timely and cost‐effective manner’;
Whereas Article 44 of the Convention on International Civil Aviation states that ‘The aims and objectives of the Organization are to develop the principles and techniques of international air navigation and to foster the planning and development of international air transport so as to ...[m]eet the needs of the peoples of the world for safe, regular, efficient and economical air transport’;
Whereas Annex 6 – Operation of Aircraft, Annex 9 – Facilitation, Annex 11 – Air Traffic Services, Annex 14 – Aerodromes, Volume I — Aerodrome Design and Operations to the Convention on International Civil Aviation and the Procedures for Air Navigation Service – Air Traffic Management (Doc 4444) contain several Standards and Recommended Practices and Procedures relating to health measures that should be taken by Contracting States to manage public health emergencies of international concern and to prevent the spread of communicable disease by air travel;
Whereas the ICAO Cooperative Arrangement for the Prevention of Spread of Communicable Disease through Air Travel (CAPSCA) project is an appropriate measure to improve and harmonize preparedness plans;
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Other ongoing work with WHO/other stakeholders
• Aircraft disinsection
• Aircraft disinfection
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International Civil Aviation Organization
ICAO SARPs
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Relevant ICAO SARPs/Guidelines ‐ see“Health Related Documents” on CASPCA website
• Annex 6 ‐ Operation of Aircraft
• Annex 9 ‐ Facilitation
• Annex 11 ‐ Air Traffic Services
– Procedures for Air Navigation Services – Air Traffic Management (PANS‐ATM)
• Annex 14 ‐ Aerodromes
• ICAO Guidelines for States
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ICAO Standards and recommended Practices
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Other potential crises
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International Civil Aviation Organization
Questionnaire on preparedness
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Communicable Disease Questionnaire
• State letter (EC 6/22‐10/51, 22 June 2010) –“National Aviation Plan: Communicable Diseases”
Responses from Americas = 13• North Am. – 5• South Am. ‐ 8• Deadline for replies: 30th
June 2011 (extended from October)
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State letter
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Funding
• UN Central Fund for Influenza Action
– Primary funding
• States (countries)
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Audit protocol questions
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CMA SAAQ
SAAQ
REF.
SAAQ QUESTION INFORMATION PROVIDED BY STATE
COMMENTS
ORG Has the State identified a clear contact point at
national aviation level, with identified
individual(s), 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?
Yes No
If yes, provide name and contact
details
New question
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Audit protocol questions
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A9 8.15PANS
ATM Doc 4444 16.6.1
Does the aircraft operations organization ensure that the air operator has established procedures for the pilot in command to report promptly to ATC a suspected communicable disease?
□ Yes□ No
Review operations inspectors procedures to ensure they check air operators related procedures
Sample an air operator procedure in operations manual
Ensure, in the procedure, that the following information is transmitted by the crew:
a) aircraft identification;b) departure aerodrome;c) destinationaerodrome;d) estimated time ofarrival;e) number of persons onboard;f) number of suspectedcase(s) on board; andg) nature of the publichealth risk, if known.
□ Satisfactory□ Not satisfactory
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Audit protocol questions
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ICAO ref. Protocol question Reply Guidance for review of protocol question
Status of implementation Evidence/Notes/CommentsCE
A9 8.15 Note 1
A9 2.10 & App1
A6 6.2 and AttB
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?
□ Yes□ No
Review operations inspectors procedures to ensure they check air operators related procedures
Sample an air operator procedure in operations manual or cabin crew manual
Check the procedure includes the transmission, as required, of a General Declaration form to the State authorities.
□ Satisfactory□ Not satisfactory
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CAPSCA‐Frankfurt July 2012
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?
ICAO Standards and Recommended Practices + Guidelines for States
CAPSCA‐Frankfurt July 2012
www.CAPSCA.org
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Audit Protocols
• Questions on preparedness planning will be included in ICAO Universal Safety Oversight Audit Programme questions:
– “Protocol questions”
• Undergoing testing in selected States
• To be introduced from 2013
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Audit Example 1
“Has the State identified a clear contact point at national aviation level, with identified individual(s), 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?”
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Audit Example 2
“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?”
CAPSCA‐Frankfurt July 2012
Audit Example 3
“Does the aircraft operations organization ensure that the air operator has established procedures for the pilot in command to report promptly to ATC a suspected communicable disease?”
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