IHR (2005) implementation at PoE Global Overview Workshop on IHR core capacities strengthening and Ship Sanitation Certificates PAGnet 14-18 June 2010, Fortaleza, Brazil Daniel Lins Menucci Ports, Airports and Ground Crossings - PAG Coordination HSE/IHR/PAG- Lyon Office
CAPSCA Ports Airports Ground crossings EXPECTED RESULTS 1. Facilities used by travellers at points of entry are maintained in a sanitary condition and are kept free of infection or contamination, including vectors and reservoirs. IHR Annex 1B, (also 3, 4, 5, 8, and 9) 2. Routine measures, in compliance with IHR (2005), are in place for travellers, conveyances, cargo, goods and postal parcels. 3. A public health contingency plan for public health emergencies is effectively available and operational at all designated PoE and in all countries. 4. Designated points of entry have the capacity to rapidly implement international public health recommendations. 5. Coordination exists between WHO and other relevant UN and intergovernmental organizations, industry associations and travel-related professional associations.
IHR implementation at ports, airports and ground crossings PREVENTION EARLY WARINING RESPONSE Containing known public health risks Detecting relevant health events Responding to public health emergencies Routine control of Sanitary conditions at points of entry and conveyances Risk management Inspection, screening, Information and verification Risk assessment Support to investigation and contingency plans to adopt control measures Event management Conveyances inspection programmes and control measures
Main approaches Global, Regional and sub-regional cooperation projects Country support (TTC, Core Capacicities Ass.&Planing, legislation) Harmonization with others international instruments and procedures Guidance documents and electronic tools E-library (http://www.who.int/ihr/elibrary) Training initiatives Preparedness and response Networks and collaborating Centers (PAGnet, Hamburg Port Health Center, CDC)
Regional and Country Office Engagement WHO s regional and country offices play a vital role in support of countries engagement with partnerships providing reinforcement of national capacity to manage multiple activities and financial flows (when partnerships are active at country level), including for IHR implementation.
Harmonization with others international instruments and procedures
Cooperation with ICAO and IATA Revision of IHR Health Documents Action taken Health Part of the Aircraft General Declaration Part of ICAO document: it was updated and entered into force July 15 th 2007 and will replace IHR Annex IX Passenger Locator Card - developed with WHO and IATA support and approved by ICAO Recommended measures response to an event of communicable disease ICAO guidance, with WHO support. Guidelines to States for developing airport emergency plans (CAPSCA) (www.icao.int/icao/en/med/guidelines.htm) IATA - General Guidelines for Cabin Crews when facing a suspected case of communicable disease on board (WWW.IATA.ORG)
Guidance and tools for POE Air transport and airport guidelines Guide to Hygiene and Sanitation in Aviation Tuberculosis and Air Travel WHO Technical Advice for Case Management of Influenza A(H1N1) in Air Transport Ship travel and port guidelines International Medical Guide for Ships Interim WHO Technical Advice for Case Management of Pandemic H1N1(2009) on ship Guide to Ship Sanitation Recommended Procedures for Inspection of Ships and Issuance of Ship Sanitatio Certificate Ground transport and ground crossings WHO guide to ground Crossing IHR (2005) Core Capacities (draft) Core Capacity Assessment tool for core capacity requirements at designated airports, ports and ground crossings DVD (3min.) Introduction to IHR At points of entry Developing tools for supporting training programmes and health measures Technical Guidance Pandemic (H1N1) 2009 Two WHO technical advice for case management of Influenza A (H1N1): for air travel ships WPRO Regional Office Guidance on Risk Assessment for PH measures at points of entry. International survey of Health Measures at ports, airports and ground crossings. Published in WHO WER 21 May
Assessment tool for core capacity requirements at designated airports, ports and ground crossings Check list (appendix 1) Published at WHO IHR website
Assessment tool for core capacity requirements at designated airports, ports and ground crossings Manual & Model of Excel Spreadsheet File Appendix 2
Ship Medical Guide & H1N1 Guidance Published in 2007
Ship Sanitation & SSC Inspection Guidelines Informal Consultation Meeting Lyon October 2009 NEW DRAFT PEER REVIEW APRIL- June 2010 Publication 2010
Air Transportation Published in 2008 Published in May 2009
Ground Crossings WHO GUIDE TO GROUND CROSSING IHR (2005) working document drafted Meetings Canada 2004, Brazil 2008 El Paso, Texas. March 24 to 26, 2010 Fortaleza, 13 June 2010
Introduction to IHR at PoE and Interactive training tool for Implementation of Ship Sanitation Certificates 3 Min. DVD Introduction to IHR at points of entry, describing main requirements, deadlines and core capacities. Interactive DVD for individual training on inspection and issuance of Ship Sanitation Certificates Under development in cooperation with WHO, MoH France and Hamburg Port Health Center
IHR Implementation Course Georgetown University USA 210 heures Distance face-à-face CERTIFICATE WHO UNIVERSITES Pretoria University COLLABORATION Geneva University Switzerland South Africa Institut Bioforce Développement, Fondation Mérieux, France, USA 22 March - 30 July 2010 37 participants 32 countries 6 WHO Regions Qualified staff to implement IHR in Member States Second course: 13 Septembre 2010 21 January 2011
Preparedness and response at PoE CAPSCA / ICAO Cooperative Arrangements for Preventing international Spread of Communicable Disease through Air transpo Contingency plans for public health emergency at airports. International collaboration for harmonizing response and dissemination of information (e.g. UNWTO-TERN) Monitoring application of public health measures at PoE related to travel & trade (Source: GPHIN, MoH websites, UNWTO etc.) Increased preparedness with workshops, field exercises and drills a cross borders and PoE
Pandemic (H1N1) 2009 WHO Support for PoE related activities nternational collaboration for harmonzing response nd dissemination of information Travel and tourism sector: UNWTO/TERN, Maritime sector: IMO, CLIA, ISF Aviation sector: ICAO, IATA, ACI Travel and health professionals: IMHA, ISTM onitoring application of public health measures at oe related to travel & trade Source: GPHIN, MoH websites, WTO, notification, media
Pandemic (H1N1) 2009 WHO Support for PoE related activities wo WHO technical advice for case management of nfluenza A (H1N1): air travel and also for ships PRO Regional Office Guidance on Risk ssessment for PH measures at points of entry. nternational survey of Health Measures at ports, irports and ground crossings. First results ublished at WHO WER (21 MAY 2010)
Intersectoral collaboration Exercise for public emergency Spain 2008-2009
Ports Listing Summary April 30 2010 States Listing Ports by Region 75 Member States : 1744 Ports WPRO, 14 AFRO, 3 AMRO, 16 AFRO AMRO 3 16 SEARO, 4 EMRO 8 EURO, 30 EMRO, 8 EURO SEARO WPRO 30 4 14 Total 75 AFRO 6 Nr of Ports Listed by Region AMRO EMRO EURO SEARO WPRO Total 406 70 709 76 477 1744,WPROAFRO, 6 477,SEARO 76,AMRO 406,EURO 709 EMRO, 70
Ship Sanitation Certificates - SSC Lessons learned Old deratting certificate (IHR 1969) still being issued Using different model of SSC (Annex 3) Ports issuing SSC and not at WHO list Name of port in the SSC different from WHO list Issuance of Control Exemption Certificates - SSCEC when control measures are required Inadequacy of notes at Control Certificates - SSCC about evidence found and measures
Ship Sanitation Certificates - SSC Lessons learned HE DISSEMINATION OF IHR REQUIREMENTS IS NO REACHING THE PORTS Lack of knowledge about ship inspection and IHR: Need to disseminate information and training Procedures, criteria and administrative arrangements for ship inspection and issuance of SSC at ports are out of date and need to be updated Identify and inform WHO about ports authorized to issue SSC, for publication, is needed
Inter countries collaboration Ship Sanitation Workshops CDC - USA and Caribbean Countries Florida 2008 Portuguese Speaking Countries Sines - Portugal 2008 & Fortaleza Brazil Jul.2010
Vector control at PoE PoE Vector control for >400 metres from passenger terminals and operational areas Every conveyance leaving an area where vector control is recommended by WHO should be disinsected and also permanently kept free of vectors and reservoirs. To use methods and materials advised by WHO, when they are available. LESSONS LEARNED The need for vector control has been re-emphasized with revised IHR Application of disinsection is not always conducted according to WHO recommendations and vector populations are increasingly resistant to pyrethroids It is not easy to measure efficacy of the procedures under real life situations. Guidelines sometimes conflict with commercial pressure Lack of training on disinsection procedures Good experience in cross cutting collaboration within WHO technical areas, countries, international organizations and transport sector for testing and revising method
Vector control at PoE Revision of criteria, methods and guidelines HO activities related to IHR Annex V Developing risk assessment model for future consultation meeting to assess the risks of the specific chemicals Developing standards for effectiveness for chemicals and methods Determining list of areas where disinsection are recommended for aircraft arriving from these areas Future collaboration for PoE global vector databas
Aircraft disinsection CAO Gen. Assembly Res. A36-24 (September 2007) HO to hold a consultation on the disinsection of the cabin and flight deck, exploring non-chemical approach and to report to next ICAO General Assembly Air curtain experiment ICAO WHO Milestones 2009 2008 2010 Gainesville meeting - Florida, Dec. Follow up meeting of mechanical disinsection working group Montreal,July To report to ICAO General Assembly
PAG Database T Tool to come into peration soon Replacing the urrent PDF format orts list for a ynamic data base to ontain key IHR nformation equirements Authorities to provide to WHO information about designated PoE and contacte details of competent authorities at ports/airports/ground crossings
PAGNet Ports, airports and ground crossings network PAGnet Informal network of partners and experts of public health, points of entry and international travel and transport
PAGNET STRUCTURE ANNUAL MEETING NEXT JULY 20 Health Authorities FUNDS + Technical collaboration burg Port Health Center Members others sectors C D C W.H.O. Advisory Group OTHERS H P H C PAGNET Moderator Technical Groups Regulations International Framework 1 2 3 4 5 6 Ports and Airport and Ground Crossings Vectors and Passengers and Ships Aircrafts Ground Transport Reservoirs Crew Members Health 7 Emergency Preparedness
Helpful Links - Join the PAGNet Partnership - Join our Mailing List - IHR - FAQs on Travel and Transport - FAQs on PAGNet - International Travel and Health - International Organizations - Points of entry database Partners
Implementation of IHR at PoE How to go further on Monitoring designation, development and implementing IHR core capacities at PoE. Strengthening intersectoral coordination and collaboration for designation, assessment and development of routine and response core capacity at PoE (e.g. transport, customs, immigration, environment, etc.). Harmonization of activities at PoE with national health surveillance and response system. National harmonization of IHR requirements with commitments/requirements from others International agreements (e.g. ICAO, IMO, ILO Conventions) WHO Certification for ports and airports at voluntary basis
HR PoE & International travel and transport MAJOR CHALLENGE Keep travel and tourism operating Keep ships sailing and ports operating Keep aircraft flying and airport running Keep ground transport running and crossing borders ll in a safe and healthy manner, protecting people & voiding international spread of diseases and agents
PUBLIC HEALTH Thank you Gracias Merci Obrigado ihrpag@who.int w w w. w h o. i n t / ihr/ports_airports/en/