Facilitation: Annex 9 to the Convention on International Civil Aviation (ICAO)

Today, with the COVID-19 crisis, some think they have to come up with novel travel measures to adapt civil aviation to the pandemic. They are trying to re-invent the wheel. Many procedures for dealing with infectious diseases in aviation are already Regulated and Standardised at the International Civil Aviation Organisation (ICAO), the United Nations' Aviation body to which Canada is a member.

The Chicago Convention which created ICAO and to which Canada is a signatory states in its article 14:

Article 14 – Prevention of spread of disease 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, ... — Establish, review and amend as necessary the national policies regarding prevention of the spread of contagious diseases by air, for example, aircraft disinsection, disinfection, public health-related quarantine programmes, and screening measures to be applied in a health emergency. 

Nineteen Annexes are appended to the Convention. One of them, Annexe 9 is called Annex 9 to the Convention on International Civil Aviation, Facilitation which already covers most of these things. All measures taken by the States to protect air travellers from COVID-19 should be implemented in conformity with these ICAO International Standards and Recommended Practices (SARPS).

https://www.icao.int/Security/FAL/Pages/Annex9.aspx

Let's not try to re-invent what already exists.

Only through coordinated and standardised international efforts will civial aviation survive this crisis. Nations must work together to come up with viable solutions and this must be achieved through ICAO and IATA. By dealing unilaterally, States, including Canada, will fail in their efforts or prolong the crisis.

Let's review what Annex 9 to the Chicago Convention has to say about Health measures:

Definitions:

Disinfection. The procedure whereby health measures are taken to control or kill infectious agents on a human or animal body, in or on affected parts of aircraft, baggage, cargo, goods or containers, as required, by direct exposure to chemical or physical agents.

International airport. Any airport designated by the Contracting State in whose territory it is situated as an airport of entry and departure for international air traffic, where the formalities incident to customs, immigration, public health, animal and plant quarantine and similar procedures are carried out.

Public health emergency of international concern. An extraordinary event which is determined, as provided in the International Health Regulations (2005) of the World Health Organization: (i) to constitute a public health risk to other States through the international spread of disease and (ii) to potentially require a coordinated international response.

Public health risk. A likelihood of an event that may affect adversely the health of human populations, with an emphasis on one which may spread internationally or may present a serious and direct danger.

ICAO Standards and Recommended Practices (SARPS) of ANNEX 9

2.4 Contracting States shall not prevent an aircraft from calling at any international airport for public health reasons unless such action is taken in accordance with the International Health Regulations (2005) of the World Health Organization. 

2.4.1 Recommended Practice.— In cases where, in exceptional circumstances, air transport service suspensions on public health grounds are under consideration, Contracting States should first consult with the World Health Organization and the health authority of the State of occurrence of the disease before taking any decision as to the suspension of air transport services.

2.5 If, in response to a specific public health risk or a public health emergency of international concern, a Contracting State is considering introduction of health measures in addition to those recommended by WHO, it shall do so in accordance with the International Health Regulations (2005), including but not limited to Article 43, which states, in part, that when determining whether to implement the additional health measures States Parties shall base their determinations upon: (a) scientific principles; (b) available scientific evidence of a risk to human health, or where such evidence is insufficient, the available information including from WHO and other relevant intergovernmental organizations and international bodies; and (c) any available specific guidance or advice from WHO. 

Note 1.— Standard 2.5 applies only to those situations where there is an official IHR (2005) Temporary Recommendation (i.e. in the context of a declared public health emergency of international concern), or a Standing Recommendation in effect. These requirements in Article 43 can also apply to other contexts involving additional measures applied to international traffic (including aircraft), such as IHR Articles 23 2), 27 1) and 28. 

Note 2.— Article 43 of the IHR (2005) also requires that a State that implements additional measures thereunder that significantly interfere with international traffic is required to provide to WHO the public health and scientific rationale for such measures. 

2.5.1 Recommended Practice.— Any State impacted by a measure taken under Standard 2.4, or a suspension as described in Recommended Practice 2.4.1, should, where appropriate, request the State implementing such a measure to consult with it. The purpose of such consultations would be to clarify the scientific information and public health rationale underlying the measure and to find a mutually acceptable solution.

2.31 Contracting States shall determine the conditions under which aircraft are disinfected. When aircraft disinfection is required, the following provisions shall apply: a) the application shall be limited solely to the container or to the compartment of the aircraft in which the traffic was carried; b) the disinfection shall be undertaken by procedures that are in accordance with the aircraft manufacturer and any advice from WHO; c) the contaminated areas shall be disinfected with compounds possessing suitable germicidal properties appropriate to the suspected infectious agent; d) the disinfection shall be carried out expeditiously by cleaners wearing suitable personal protective equipment; and e) flammable chemical compounds, solutions or their residues likely to damage aircraft structure, or its systems, such as by corrosion, or chemicals likely to damage the health of passengers or crew, shall not be employed. Note.— When aircraft disinfection is required for animal health reasons, only those methods and disinfectants recommended by the International Office of Epizootics should be used.

2.32 Contracting States shall ensure that where there is contamination of surfaces or equipment of the aircraft by any bodily fluids including excreta, the contaminated areas and used equipment or tools shall be disinfected.

3.31 In cases where proof of vaccination or prophylaxis is required by national authorities under the International Health Regulations (2005), Contracting States shall accept the International Certificate of Vaccination or Prophylaxis prescribed by the World Health Organization in the IHR (2005). 

6.1.3 Each Contracting State shall ensure that efficient customs, immigration, quarantine and health border clearance services, as required, are provided at international airports. 

6.34 Each Contracting State, in cooperation with airport operators, shall ensure the maintenance of public health, including human, animal and plant quarantine at international airports.

6.35 Recommended Practice.— Contracting States should ensure that there are, at or near all their major international airports, facilities and services for vaccination or revaccination, and for the delivery of the corresponding certificates.

6.36 Recommended Practice.— International airports should have available access to appropriate facilities for administration of public health and animal and plant quarantine measures applicable to aircraft, crew, passengers, baggage, cargo, mail and stores. 

?6.37 Recommended Practice.— Contracting States should ensure that passengers and crew in transit can remain in premises free from any danger of infection and insect vectors of diseases and, when necessary, facilities should be provided for the transfer of passengers and crew to another terminal or airport nearby without exposure to any health hazard. Similar arrangements and facilities should also be made available in respect of animals.

6.38 Each Contracting State shall ensure that handling and distribution procedures for consumable products (i.e. food, drink and water supplies) on board aircraft or in the airport are in compliance with the International Health Regulations (2005) and relevant guidelines of the World Health Organization, the Food and Agriculture Organization and national airport regulations.

6.39 Each Contracting State, in cooperation with airport and aircraft operators, shall ensure that a safe, sanitary and efficient system is instituted, at international airports, for the removal and disposal of all waste, waste water and other matters dangerous to the health of persons, animals or plants, in compliance with the International Health Regulations (2005) and relevant guidelines of the World Health Organization, the Food and Agriculture Organization and national airport regulations.

6.40 Each Contracting State, in cooperation with airport operators, shall ensure that international airports maintain facilities and services for first-aid attendance on site, and that appropriate arrangements are available for expeditious referral of the occasional more serious case to prearranged competent medical attention. 

Note.— Consultation with the World Health Organization on all issues concerning passenger health is advisable. 

6.42 Recommended Practice.— Each Contracting State should consider making arrangements with other States to station representatives of the public authorities concerned in its territory in order to pre-examine aircraft, passengers, baggage, crew, and cargo, for customs, immigration, public health and animal and plant quarantine purposes, prior to departure when such action will facilitate clearance upon arrival in those States. 

8.12 Contracting States shall comply with the pertinent provisions of the International Health Regulations (2005) of the World Health Organization.

8.13 Contracting States shall take all possible measures to have vaccinators use the Model International Certificate of Vaccination or Prophylaxis, in accordance with Article 36 and Annex 6 of the International Health Regulations (2005), in order to assure uniform acceptance. 

8.14 Each Contracting State shall make arrangements to enable all aircraft operators and agencies concerned to make available to passengers, sufficiently in advance of departure, information concerning the vaccination requirements of the countries of destination, as well as the Model International Certificate of Vaccination or Prophylaxis conforming to Article 36 and Annex 6 of the International Health Regulations (2005).

8.15 The pilot-in-command of an aircraft shall ensure that a suspected communicable disease is reported promptly to air traffic control, 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. 

Note 1.— A communicable disease could be suspected and require further evaluation if a person has a fever (temperature 38°C/100°F or greater) that is associated with certain signs or symptoms: e.g. appearing obviously unwell; persistent coughing; impaired breathing; persistent diarrhoea; persistent vomiting; skin rash; bruising or bleeding without previous injury; or, confusion of recent onset.

Note 2.— In the event of a case of suspected communicable disease on board an aircraft, the pilot-in-command may need to follow his operator’s protocols and procedures, in addition to health-related legal requirements of the countries of departure and/or destination. The latter would normally be found in the Aeronautical Information Publications (AIPs) of the States concerned.

Note 3.— Annex 6 — Operation of Aircraft describes the “on board” medical supplies that are required to be carried on aircraft. The Procedures for Air Navigation Services — Air Traffic Management (Doc 4444) (PANS-ATM) detail the procedures to be followed by the pilot-in-command in communication with air traffic control.

8.15.1 Recommended Practice.— When a public health threat has been identified, and when the public health authorities of a Contracting State require information concerning passengers’ and/or crews’ travel itineraries or contact information for the purposes of tracing persons who may have been exposed to a communicable disease, that Contracting State should accept the “Public Health Passenger Locator Form” reproduced in Appendix 13 as the sole document for this purpose. Note.— It is suggested that States make available adequate stocks of the Passenger Locator Form, for use at their international airports and for distribution to aircraft operators, for completion by passengers and crew. 

8.16 A Contracting State shall 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. Note 1.— Guidance in developing a national aviation plan may be found on the ICAO website on the Aviation Medicine page. Note 2.— Annex 11 — Air Traffic Services and Annex 14 — Aerodromes, Volume I — Aerodrome Design and Operations require air traffic services and aerodromes to establish contingency planning or aerodrome emergency plans, respectively, for public health emergencies of international concern.