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A look at aviation regulations from a health perspective

In recent times, the world has been faced with a major health challenge ; the COVID -19 pandemic.  A number of countries have placed partial or total travel bans on ships or aircrafts from certain parts of the world where the COVID- 19 is on rampage. The major reason for the said bans is to curb the spread of the COVID -19 virus and to safeguard the health of citizens of such countries.

There were also calls from various quarters urging the Nigerian government to place travel bans accordingly in order to reduce the chances of anyone with the virus coming into the country. The Nigerian government eventually heeded these calls and placed travel bans accordingly to safeguard the health of its citizens. A lot of questions might be going through the minds of many at a time like this on whether aviation regulations to safeguard the health of citizens in Nigeria are in existence or not. This article will attempt to highlight existing health related provisions of aviation regulations in Nigeria.

Nigerian Civil Aviation Authority(NCAA) is the regulatory body for aviation in Nigeria. It became autonomous with the passing into law of the Civil Aviation Act 2006. The Act not only empowers the Authority to regulate Aviation Safety without political interference but to also carry out oversight functions of Airports, Airspace, Meteorological Services, etc as well as economic regulations of the industry.

The NCAA also has a number of regulations which deal with various aspects of aviation. Part 18 of the NCAA regulations has a number of provisions that deal specifically with health related issues. Some of these health related provisions are as follows;

Preventing the entry of an aircraft

Section 18.8.9.3  provides that no airport operator shall prevent any aircraft from landing at any international airport for public health reason(s) unless such action is taken in accordance with the International Health Regulations (IHR) 2005 of World Health Organization (WHO).  This indicates that an Aircraft can be stopped from entering into Nigeria as a result of public health reasons. However, this can only be done  in accordance with the IHR of WHO.  Article 28 of IHR, 2005 states that subject to Article 43 or as provided in applicable international agreements, a ship or an aircraft shall not be prevented for public health reasons from calling at any point of entry. However, if the point of entry is not equipped for applying health measures under these Regulations, the ship or aircraft may be ordered to proceed at its own risk to the nearest suitable point of entry available to it, unless the ship or aircraft has an operational problem which would make this diversion unsafe.

Article 43 of IHR, 2005 provides that a country shall base their refusal to allow an aircraft to enter 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 organisations and international bodies; and (c) any available specific guidance or advice from WHO. Furthermore,  a country wishing to prevent the entry of an aircraft into its territory shall provide to WHO the public health rationale and relevant scientific information for it. WHO shall share this information with other countries. After assessing information provided and other relevant information, WHO may request that the country concerned to reconsider the prevention of entry of an Aircraft. A country that intends to implement travel bans/restriction measures has an obligation to inform WHO, within 48 hours of implementation, of such measures and their health rationale unless these are covered by a temporary or standing recommendation by WHO.

A country implementing a travel ban or restriction, shall within three months review such a measure taking into account the advice of WHO.

Proof of vaccination

There are instances where an individual is required to have been vaccinated against certain diseases and also show proof of such vaccination before he or she can be allowed to enter into a country.  Section18.8.20.1. of the NCAA Regulations provides that in such cases where proof of vaccination or prophylaxis is required by national authorities under the IHR (2005) e.g. yellow fever, the Authority shall accept the International Certificate of Vaccination or Prophylaxis prescribed by the WHO in the IHR (2005).

Disinsection and disinfection of aircraft.

 

The NCAA regulates both disinsection and disinfection of Aircrafts. Disinsection refers to the process of getting rid of disease causing insects while disinfection refers to the process of getting rid of disease causing microbes. NCAA has a duty to limit any routine requirement for the disinsection of aircraft cabins and flight decks with an aerosol while passengers and crews are on board, to same-aircraft operations originating in, or operating via, territories that they consider to pose a threat to their public health, agriculture or environment.- 18.8.18.1. The NCAA is also required to periodically review the requirements for the disinsection of aircraft and shall modify them, as appropriate, in the light of all available evidence relating to the transmission of insects to Nigeria via an aircraft. The NCAA is also to ensure that any insecticide or any other substance used for disinsection does not have a eleterious effect on the structure of the aircraft or its operating equipment. Flammable chemical compounds or solutions likely to damage aircraft structure, such as by corrosion, shall not be employed.

 

Section 18.8.19 provides that NCAA is to ensure that disinfection of aircrafts is carried out as follows;

 

(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.

 

Public health, emergency medical relief, and animal and plant quarantine facilities

Section  18.8.21.1. of the regulations provides that  the NCAA, in cooperation with airport operators, has a duty to ensure the maintenance of public health, including human, animal and plant quarantine facilities at international airports. Section 18.8.21.2 went further to provide that the NCAA shall 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.

The NCAA is also 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 IHR (2005) and relevant guidelines of the World Health Organization, the Food and Agriculture Organisation and national airport regulations.- 18.8.21.5.

Reporting of suspected cases of communicable diseases

Pilots in Command of aircraft have a duty to report to the Air Traffic Control any suspected cases of communicable disease on board an aircraft in line with section 18.8.22.4 of the NCAA regulations; the provision has the following guidelines with regards to a communicable disease.

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 (AIP’s.) 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) (PANSATM) detail the procedures to be followed by the pilot-in-command in communication with air traffic control.

When a public health threat has been identified, and when the public health authorities 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, the “Public Health Passenger Locator Card” shall be accepted as the sole document for this purpose.- Section18.8.22.5

The Federal Ministry of Health through the Port Health Authorities is also required to make available adequate stocks of the Passenger Locator Card, for use at international airports and for distribution to aircraft operators, for completion by passengers and crew.

Communicable disease outbreak national aviation plan

 

Section 18.8.23.1 of the regulations provides that the NCAA 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.

 

Provision of first aid and emergency medical kits

It is mandatory for airlines to have onboard each of their aircrafts, the appropriate number of First Aid Kits, Universal Precaution kits and Emergency Medical kits. This is in line with Sections 7.9.1.11 and 7.9.1.12 of the NCAA Regulations.

These provisions are quite laudable and if implemented would go a long way to safeguard the health and wellbeing of citizens. However, there is always room for improvement. It is very important that the regulations are reviewed regularly in order to meet up with global best standards and deal effectively with any emerging public health concern. A proactive approach should always be adopted especially in formulating an aviation plan to tackle an outbreak of a communicable disease posing a public health risk or public health emergency of international concern.

Uloaku Ekwegh

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