prop · GT03215 · 2006-09-15 00:00:00 — modified or extended as appropriate, including after it has been determined that a public health emergency of international concern has ended, at which time other temporary recommendations may be issued as necessary for the purpose of preventing or promptly detecting its recurrence. 2.Temporary recommendations may include health measures to be implemented by the State Party experiencing the public health emergency of international concern, or by other States Parties, regarding persons, baggage, cargo, containers, conveyances, goods and/or postal parcels to prevent or reduce the international spread of disease and avoid unnecessary interference with international traffic. 3.Temporary recommendations may be terminated in accordance with the procedure set out in Article 49 at any time and shall automatically expire three months after their issuance. They may be modified or extended for additional periods of up to three months. Temporary recommendations may not continue beyond the second World Health Assembly after the determination of the public health emergency of international concern to which they relate. Article 16 Standing recommendations WHO may make standing recommendations of appropriate health measures in accordance with Article 53 for routine or periodic application. Such measures may be applied by States Parties regarding persons, baggage, cargo, containers, conveyances, goods and/or postal parcels for specific, ongoing public health risks in order to prevent or reduce the international spread of disease and avoid unnecessary interference with international traffic. WHO may, in accordance with Article 53, modify or terminate such recommendations, as appropriate. Article 17 Criteria for recommendations When issuing, modifying or terminating temporary or standing recommendations, the Director- General shall consider: (a)the views of the States Parties directly concerned; (b)the advice of or , as the case may be; (c)scientific principles as well as available scientific evidence and information; (d)health measures that, on the basis of a risk assessment appropriate to the circumstances, are not more restrictive of international traffic and trade and are not more intrusive to persons than reasonably available alternatives that would achieve the appropriate level of health protection; (e)relevant international standards and instruments; (f)activities undertaken by other relevant intergovernmental organizations and international bodies; and (g)other appropriate and specific information relevant to the event. With respect to temporary recommendations, the consideration by the Director-General of subparagraphs (e) and (f) of this Article may be subject to limitations imposed by urgent circumstances. Article 18 Recommendations with respect to persons, baggage, cargo, containers, conveyances, goods and postal parcels 1.Recommendations issued by WHO to States Parties with respect to persons may include the following advice: no specific health measures are advised; review history in affected areas; review proof of examination and any laboratory analysis; review proof of vaccination or other prophylaxis; require vaccination or other prophylaxis; place suspect persons under public health observation; implement quarantine or other health measures for suspect persons; implement isolation and treatment where necessary of affected persons; implement tracing of contacts of suspect or affected persons; refuse entry of suspect and affected persons; refuse entry of unaffected persons to affected areas; and implement exit screening and/or restrictions on persons from affected areas. 2.Recommendations issued by WHO to States Parties with respect to baggage, cargo, containers, conveyances, goods and postal parcels may include the following advice: no specific health measures are advised; review manifest and routing; review proof of measures taken on departure or in transit to eliminate infection or contamination; implement treatment of the baggage, cargo, containers, conveyances, goods, postal parcels or human remains to remove infection or contamination, including vectors and reservoirs; the use of specific health measures to ensure the safe handling and transport of human remains; implement isolation or quarantine; seizure and destruction of infected or contaminated or suspect baggage, cargo, containers, conveyances, goods or postal parcels under controlled conditions if no available treatment or process will otherwise be successful; and refuse departure or entry. PART IV POINTS OF ENTRY Article 19 General obligations Each State Party shall, in addition to the other obligations provided for under these Regulations: (a)ensure that the capacities set forth in 1 for designated points of entry are developed within the timeframe provided in paragraph 1 of Article 5 and paragraph 1 of Article 13; (b)identify the competent authorities at each designated point of entry in its territory; and (c)furnish to WHO, as far as practicable, when requested in response to a specific potential public health risk, relevant data concerning sources of infection or contamination, including vectors and reservoirs, at its points of entry, which could result in international disease spread. Article 20 Airports and ports 1.States Parties shall designate the airports and ports that shall develop the capacities provided in 1. 2.States Parties shall ensure that Ship Sanitation Control Exemption Certificates and Ship Sanitation Control Certificates are issued in accordance with the requirements in Article 39 and the model provided in 3. 3.Each State Party shall send to WHO a list of ports authorized to offer: (a)the issuance of Ship Sanitation Control Certificates and the provision of the services referred to in Annexes 1 and 3; or (b)the issuance of Ship Sanitation Control Exemption Certificates only; and (c)extension of the Ship Sanitation Control Exemption Certificate for a period of one month until the arrival of the ship in the port at which the Certificate may be received. Each State Party shall inform WHO of any changes which may occur to the status of the listed ports. WHO shall publish the information received under this paragraph. WHO may, at the request of the State Party concerned, arrange to certify, after an appropriate investigation, that an airport or port in its territory meets the requirements referred to in paragraphs 1 and 3 of this Article. These certifications may be subject to periodic review by WHO, in consultation with the State Party. WHO, in collaboration with competent intergovernmental organizations and international bodies, shall develop and publish the certification guidelines for airports and ports under this Article. WHO shall also publish a list of certified airports and ports. Article 21 Ground crossings 1.Where justified for public health reasons, a State Party may designate ground crossings that shall develop the capacities provided in 1, taking into consideration: (a)the volume and frequency of the various types of international traffic, as compared to other points of entry, at a State Partys ground crossings which might be designated; and (b)the public health risks existing in areas in which the international traffic originates, or through which it passes, prior to arrival at a particular ground crossing. 2.States Parties sharing common borders should consider: (a)entering into bilateral or multilateral agreements or arrangements concerning prevention or control of international transmission of disease at ground crossings in accordance with Article 57; and (b) joint designation of adjacent ground crossings for the capacities in 1 in accordance with paragraph 1 of this Article. Article 22 Role of competent authorities 1.The competent authorities shall: (a)be responsible for monitoring baggage, cargo, containers, conveyances, goods, postal parcels and human remains departing and arriving from affected areas, so that they are maintained in such a condition that they are free of sources of infection or contamination, including vectors and reservoirs; (b)ensure, as far as practicable, that facilities used by travellers at points of entry are maintained in a sanitary condition and are kept free of sources of infection or contamination, including vectors and reservoirs; (c)be responsible for the supervision of any deratting, disinfection, disinsection or decontamination of baggage, cargo, containers, conveyances, goods, postal parcels and human remains or sanitary measures for persons, as appropriate under these Regulations; (d)advise conveyance operators, as far in advance as possible, of their intent to apply control measures to a conveyance, and shall provide, where available, written information concerning the methods to be employed; (e)be responsible for the supervision of the removal and safe disposal of any contaminated water or food, human or animal dejecta, wastewater and any other contaminated matter from a conveyance; (f)take all practicable measures consistent with these Regulations to monitor and control the discharge by ships of sewage, refuse, ballast water and other potentially disease-causing matter which might contaminate the waters of a port, river, canal, strait, lake or other international waterway; (g)be responsible for supervision of service providers for services concerning travellers, baggage, cargo, containers, conveyances, goods, postal parcels and human remains at points of entry, including the conduct of inspections and examinations as necessary; (h)have effective contingency arrangements to deal with an unexpected public health event; (i)communicate with the National IHR Focal Point on the relevant public health measures taken pursuant to these Regulations. 2.Health measures recommended by WHO for travellers, baggage, cargo, containers, conveyances, goods, postal parcels and human remains arriving from an affected area may be reapplied on arrival, if there are verifiable indications and/or evidence that the measures applied on departure from the affected area were unsuccessful. 3.Disinsection, deratting, disinfection, decontamination and other sanitary procedures shall be carried out so as to avoid injury and as far as possible discomfort to persons, or damage to the environment in a way which impacts on public health, or damage to baggage, cargo, containers, conveyances, goods and postal parcels. PART V PUBLIC HEALTH MEASURES Chapter I General provisions Article 23 Health measures on arrival and departure Subject to applicable international agreements and relevant articles of these Regulations, a State Party may require for public health purposes, on arrival or departure: (a)with regard to travellers: (i)information concerning the travellers destination so that the traveller may be contacted; (ii)information concerning the travellers itinerary to ascertain if there was any in or near an affected area or other possible contacts with infection or contamination prior to arrival, as well as review of the travellers health documents if they are required under these Regulations; and/or (iii) a non-invasive examination which is the least intrusive examination that would achieve the public health objective; (b) inspection of baggage, cargo, containers, conveyances, goods, postal parcels and human remains. 2.On the basis of evidence of a public health risk obtained through the measures provided in paragraph 1 of this Article, or through other means, States Parties may apply additional health measures, in accordance with these Regulations, in particular, with regard to a suspect or affected traveller, on a case-by-case basis, the least intrusive and invasive examination that would achieve the public health objective of preventing the international spread of disease. 3.No examination, vaccination, prophylaxis or health measure under these Regulations shall be carried out on travellers without their prior express informed consent or that of their parents or guardians, except as provided in paragraph 2 of Article 31, and in accordance with the law and international obligations of the State Party. 4.Travellers to be vaccinated or offered prophylaxis pursuant to these Regulations, or their parents or guardians, shall be informed of any risk associated with vaccination or with non-vaccination and with the use or non-use of prophylaxis in accordance with the law and international obligations of the State Party. States Parties shall inform practitioners of these requirements in accordance with the law of the State Party. 5.Any examination, procedure, vaccination or other prophylaxis which involves a risk of disease transmission shall only be performed on, or administered to, a traveller in accordance with established national or international safety guidelines and standards so as to minimize such a risk. Chapter II Special provisions for conveyances and conveyance operators Article 24 Conveyance operators 1.States Parties shall take all practicable measures consistent with these Regulations to ensure that conveyance operators: (a)comply with the health measures recommended by WHO and adopted by the State Party; (b)inform travellers of the health measures recommended by WHO and adopted by the State Party for application on board; and (c)permanently keep conveyances for which they are responsible free of sources of infection or contamination, including vectors and reservoirs. The application of measures to control sources of infection or contamination may be required if evidence is found. 2.Specific provisions pertaining to conveyances and conveyance operators under this Article are provided in 4. Specific measures applicable to conveyances and conveyance operators with regard to vector-borne diseases are provided in 5. Article 25 Ships and aircraft in transit Subject to Articles 27 and 43 or unless authorized by applicable international agreements, no health measure shall be applied by a State Party to: (a)a ship not coming from an affected area which passes through a canal or waterway in the territory of that State Party on its way to a port in the territory of another State. such ship shall be permitted to take on, under the supervision of the competent authority, fuel, water, food and supplies; (b)a ship which passes through waters within its jurisdiction without calling at a port or on the coast; and (c)an aircraft in transit at an airport within its jurisdiction, except that the aircraft may be restricted to a particular area of the airport with no embarking and disembarking or loading and discharging. However, any such aircraft shall be permitted to take on, under the supervision of the competent authority, fuel, water, food and supplies. Article 26 Civilian , trains and coaches in transit Subject to Articles 27 and 43 or unless authorized by applicable international agreements, no health measure shall be applied to a civilian lorry, train or coach not coming from an affected area which passes through a territory without embarking, disembarking, loading or discharging. Article 27 Affected conveyances If clinical signs or symptoms and information based on fact or evidence of a public health risk, including sources of infection and contamination, are found on board a conveyance, the competent authority shall consider the conveyance as affected and may: (a)disinfect, decontaminate, disinsect or derat the conveyance, as appropriate, or cause these measures to be carried out under its supervision; and (b)decide in each case the technique employed to secure an adequate level of control of the public health risk as provided in these Regulations. Where there are methods or materials advised by WHO for these procedures, these should be employed, unless the competent authority determines that other methods are as safe and reliable. The competent authority may implement additional health measures, including isolation of the conveyances, as necessary, to prevent the spread of disease. Such additional measures should be reported to the National IHR Focal Point. If the competent authority for the point of entry is not able to carry out the control measures required under this Article, the affected conveyance may nevertheless be allowed to depart, subject to the following conditions: (a) the competent authority shall, at the time of departure, inform the competent authority for the next known point of entry of the type of information referred to under subparagraph (b); and (b) in the case of a ship, the evidence found and the control measures required shall be noted in the Ship Sanitation Control Certificate. such conveyance shall be permitted to take on, under the supervision of the competent authority, fuel, water, food and supplies. A conveyance that has been considered as affected shall cease to be regarded as such when the competent authority is satisfied that: (a)the measures provided in paragraph 1 of this Article have been effectively carried out; (b)there are no conditions on board that could constitute a public health risk. Article 28 Ships and aircraft at points of entry 1.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. 2.Subject to Article 43 or as provided in applicable international agreements, ships or aircraft shall not be refused free pratique by States Parties for public health reasons; in particular they shall not be prevented from embarking or disembarking, discharging or loading cargo or stores, or taking on fuel, water, food and supplies. States Parties may subject the granting of free pratique to inspection and, if a source of infection or contamination is found on board, the carrying out of necessary disinfection, decontamination, disinsection or deratting, or other measures necessary to prevent the spread of the infection or contamination. 3.Whenever practicable and subject to the previous paragraph, a State Party shall authorize the granting of free pratique by radio or other communication means to a ship or an aircraft when, on the basis of information received from it prior to its arrival, the State Party is of the opinion that the arrival of the ship or aircraft will not result in the introduction or spread of disease. 4.Officers in command of ships or pilots in command of aircraft, or their agents, shall make known to the port or airport control as early as possible before arrival at the port or airport of destination any cases of illness indicative of a disease of an infectious nature or evidence of a public health risk on board as soon as such illnesses or public health risks are made known to the officer or pilot. This information must be immediately relayed to the competent authority for the port or airport. In urgent circumstances, such information should be communicated directly by the officers or pilots to the relevant port or airport authority. 5.The following shall apply if a suspect or affected aircraft or ship, for reasons beyond the control of the pilot in command of the aircraft or the officer in command of the ship, lands elsewhere than at the airport at which the aircraft was due to land or berths elsewhere than at the port at which the ship was due to berth: (a)the pilot in command of the aircraft or the officer in command of the ship or other person in charge shall make every effort to communicate without delay with the nearest competent authority; (b)as soon as the competent authority has been informed of the landing it may apply health measures recommended by WHO or other health measures provided in these Regulations; (c)unless required for emergency purposes or for communication with the competent authority, no traveller on board the aircraft or ship shall leave its vicinity and no cargo shall be removed from that vicinity, unless authorized by the competent authority; and (d)when all health measures required by the competent authority have been completed, the aircraft or ship may, so far as such health measures are concerned, proceed either to the airport or port at which it was due to land or berth, or, if for technical reasons it cannot do so, to a conveniently situated airport or port. 6.Notwithstanding the provisions contained in this Article, the officer in command of a ship or pilot in command of an aircraft may take such emergency measures as may be necessary for the health and safety of travellers on board. He or she shall inform the competent authority as early as possible concerning any measures taken pursuant to this paragraph. Article 29 Civilian , trains and coaches at points of entry WHO, in consultation with States Parties, shall develop guiding principles for applying health measures to civilian , trains and coaches at points of entry and passing through ground crossings. Chapter III Special provisions for travellers Article 30 Travellers under public health observation Subject to Article 43 or as authorized in applicable international agreements, a suspect traveller who on arrival is placed under public health observation may continue an international voyage, if the traveller does not pose an imminent public health risk and the State Party informs the competent authority of the point of entry at destination, if known, of the travellers expected arrival. On arrival, the traveller shall report to that authority. Article 31 Health measures relating to entry of travellers Invasive examination, vaccination or other prophylaxis shall not be required as a condition of entry of any traveller to the territory of a State Party, except that, subject to Articles 32, 42 and 45, these Regulations do not preclude States Parties from requiring examination, vaccination or other prophylaxis or proof of vaccination or other prophylaxis: (a)when necessary to determine whether a public health risk exists; (b)as a condition of entry for any travellers seeking temporary or permanent ; (c)as a condition of entry for any travellers pursuant to Article 43 or Annexes 6 and 7; or (d)which may be carried out pursuant to Article 23. 2.If a traveller for whom a State Party may require a examination, vaccination or other prophylaxis under paragraph 1 of this Article fails to consent to any such measure, or refuses to provide the information or the documents referred to in paragraph 1(a) of Article 23, the State Party concerned may, subject to Articles 32, 42 and 45, deny entry to that traveller. If there is evidence of an imminent public health risk, the State Party may, in accordance with its national law and to the extent necessary to control such a risk, compel the traveller to undergo or advise the traveller, pursuant to paragraph 3 of Article 23, to undergo: (a)the least invasive and intrusive examination that would achieve the public health objective; (b)vaccination or other prophylaxis; or (c)additional established health measures that prevent or control the spread of disease, including isolation, quarantine or placing the traveller under public health observation. Article 32 Treatment of travellers In implementing health measures under these Regulations, States Parties shall treat travellers with respect for their dignity, human rights and fundamental freedoms and minimize any discomfort or distress associated with such measures, including by: (a)treating all travellers with courtesy and respect; (b)taking into consideration the gender, sociocultural, ethnic or religious concerns of travellers; and