Management of Public Health Events in Air Transport Training

Management of Public Health Events in Air Transport Training ICAO-WHO Sixth Meeting of the CAPSCA-EUR NAT Programme CAPSCA Workshop and Training for Technical Advisors Minsk, Belarus July 12, 2017

Emergency / Contingency Plans Civil Aviation Public Health National National Aviation Plan for a Public Health Emergency ICAO Annex 9 ICAO Facilitation Manual CAPSCA Template for an Aviation Public Health Emergency Preparedness Plan National Public Health Emergency Contingency Plan Aviation & PoEs WHO International Health Regulations (IHR) Airport Aerodrome Emergency Plan Public Health Emergencies procedures for initial response to unexpected event until handing over to appropriate authority (e.g. report of suspected case on board of arriving aircraft) ICAO Annex 14 & Doc 4444 (PANS-ATM) ICAO Airport Emergency Planning Manual Aviation SOPs Airport Public Health Emergency Contingency Plan core capacities and procedures for managing public health event (local outbreak or PHEIC) WHO International Health Regulations (IHR) Annex 1B WHO Guide for Public Health Emergency Contingency Planning at Designated Points of Entry Health SOPs

Aviation Emergency Contingency Plans State / National level National Aviation Plan, developed by national civil aviation authority, in line with ICAO SARPS National Public Health Emergency contingency plan, developed by Ministry of Health with relevant stakeholders including PoE Point of Entry (Airport) Each international aerodrome must have an Aerodrome Emergency Plan Airport emergency plan should include a public health component, developed between the aerodrome and public health authorities

Emergency Plans at PoE Lessons learned from Pandemic and other events Need for preparedness (past experience and training counts ) Updating/validating guidance and tools, Revising standards Cooperation and coordination as key issue Risk assessment and risk communication Political pressure and potential and real impact of event on decision making and adopting health measures Globalization of information and risk perception IHR and new role of PoE (NOT ONLY ENTRY BARRIERS ) The traveller and employees and its potential active role.

Developing a PHECP at designated POE is an important minimum requirement under IHR Improving and sustaining readiness is a continuing process (e.g. EOC, risk assessment capacity and operational research) A broader approach is required to operationalize the plans (local, national and international context)

IHR Requirements for Core capacities AT ALL TIMES (ROUTINE) Designation of PoE for development of core capacities for routine and emergency response. (Arts.19,20 21 and Annex 1B)

Capacity requirements for responding to potential PHEIC (emergency) g a Public Health Emergency Contingency plan: coordinator, contact points for relevant PoE, PH & other agencies Transfer of travellers with infection/ contamination: Provide access to required equipment, personnel with protection gear for f b Provide assessment & care for affected travellers or animals: arrangements with medical, veterinary facilities for isolation, treatment & other services To apply entry/exist control for departing & arriving passengers e c Interview suspect or affected persons: Provide space, separate from other travellers Assessment and quarantine of suspect or affected travellers: d To apply recommended measures: disinsect, disinfect, decontaminate, baggage, cargo, containers, conveyances, goods, postal parcels, etc preferably in facilities away from airport

IHR Requirements for Core capacities FOR COORDINATION AND COMMUNICATION OF EVENT Designation of PoE for development of core capacities for routine and emergency response. (Arts.19,20 21 and Annex 1A) (a) International communication link with competent authorities at other points of entry (b) National communication link between competent authorities at points of entry and health authorities at local, intermediate and national levels (e) Assessment of all reports of urgent events within 24 hours (c) Direct operational link with other senior health officials (d) Communication link with conveyance operators, travellers for health related information, with service providers (e) Procedures and legal and administrative provisions to conduct inspections and receive reports of cases of illness and or other evidence of public health risk on board arriving conveyances (f) Communication mechanism for the dissemination of information and recommendations received from WHO WHO

Piloted in Accra, Ghana May 8-10, 2017 ICAO, Airport Authority, Port Health, WHO Country Office all participated Multi-sectoral approach (Customs, Immigration) Exceptional response from WHO AFRO and ICAO Next Steps Train the Trainer from the 47 African Countries English Session Accra, Ghana, Oct 31 to Nov 2, 2017 French Session Dakar, Senegal Dec. 5-7, 2017 Portuguese Session- Mozambique Q1 2018 E-learning version Q1 2018

Developing a PHECP at designated POE is an important minimum requirement under IHR Improving and sustaining readiness is a continuing process (e.g. EOC, risk assessment capacity and operational research) A broader approach is required to operationalize the plans (local, national and international context)

Managing Public Health Events at PoE Hospitals & facilities Arrangements: - transportation - treatment - isolation - diagnosis PoE Arrangements - Quarantine - Conveyance inspection - vector control - disinfection Coordinator WHO Public health authority: National Surveillance and Response system Infect. Dis.. security Mechanisms: - Event communication - Collaborative investigation - Coordinated response (e.g. examination, disinsection, derating, disinfection, decontamination, contact tracing, etc) Relevant sectors & stakeholders NFP

Managing Public Health Events at PoE Synergies between Public Health and International travel and transport sectors IHR (2005) annex 9 and Convention of Intentional Civil Aviation Annex 9 Facilitation Health part of aircraft general declaration Air Sector Fever (38 C/100 F or greater) plus one or more of the following signs or symptoms: Appearing obviously unwell Persistent coughing Impaired breathing Persistent diarrhoea Persistent vomiting Skin rash Bruising or bleeding without previous injury Confusion of recent onset

Managing Public Health Events at PoE Synergies between Public Health and International travel and transport sectors Air Sector HR (2005) annex 9 and Convention of Intentional Civil Aviation Annex 9 - Facilitation Health part of aircraft general declaration Pilot-in-command to notify ATC as soon as he is aware of a suspected case of communicable disease on board ( IHR Art 28)

WHO Guidance and Tools related to PoE

PUBLIC HEALTH Thank you شكرا Merci ihrpag@who.int w w w. w h o. i n t / ihr/ports_airports/en/ Gracias 谢谢 Obrigado