IATA’s Medical Advisor discusses aviation’s role in communicable disease outbreaks and lessons learned from recent cases.

An outbreak of communicable disease always represents a threat for the industry. On top of the main threat to employees, passengers and the general public, outbreaks can lead to disrupted operations, reputational risk, interruption of services in the supply chain and decreased travel demand, among other things.

The importance of a threat depends mainly on two factors: the type of disease involved and how fast the outbreak is detected and quantified. Any delay can potentially cost lives.

While the onus should not rest on airports and airlines to diagnose and treat infections, they are increasingly becoming critical assets in managing a potential outbreak

As we saw with the outbreak of H1N1, the health consequences of the illness turned out to be limited, but because it took a long time to quantify it and coordinate, the industry economy was affected, albeit not as much as if the disease had a higher morbidity and mortality rate.

While the onus should not rest on airports and airlines to diagnose and treat infections, they are increasingly becoming critical assets in managing a potential outbreak.

For instance, airports can be used by public health authorities to set up exit or entry screening procedures using different technologies. If the problem has been missed at the airport or has appeared after departure, the airlines can also help by following the IATA guidelines on how to suspect a communicable disease on board.

Besides being at the forefront to detect possible communicable diseases, the airlines also have a critical role during an outbreak by transporting health care workers and medical supplies to the affected state(s). At the same time, they need to protect their own employees and customers. The safety and wellbeing of people is the top priority at all times.

The main consideration for aviation stakeholders—for airlines in both emerging and mature economies—is to recognize early a potential communicable disease and follow IATA procedures for those cases

In the context of increased urbanization from emerging markets in Asia, Latin America and Africa, heightened mobility from these markets might increase the spread of communicable diseases. Some diseases that were once limited to remote areas may now be found in urban areas and spread further from there.

Although the details are not all known, the recent outbreak of plague in Madagascar may be an example of this. Plague has long been endemic to Madagascar, but was mainly found in remote areas. Last year it appeared in urban areas and spread.

The main consideration for aviation stakeholders—for airlines in both emerging and mature economies—is to recognize early a potential communicable disease and follow IATA procedures for those cases.

On paper there is a global approach to managing infectious diseases; the approach is led by the World Health Organization (WHO) using the International Health Regulations (IHR) that have been approved by WHO Member States.

Fundamentally, the industry needs to understand its role in managing a health emergency before a crisis hits

However, for many reasons it does not work as well as it should. As experience with past outbreaks has shown, several WHO Member States do not always follow WHO and IHR regulations and proclaim their own rules, which may create major difficulties for the other stakeholders.

The IHR Review Committee made recommendations for improvement after the Ebola outbreak and hopefully these recommendations will be implemented.

Fundamentally, the industry needs to understand its role in managing a health emergency before a crisis hits. During the outbreak of Zika, for example, ICAO formed and chaired an Aviation Medical Forum, where IATA, ACI (Airport Council International), IFALPA (International Federation of Airline Pilot Associations), and ITF (International Transport Workers’ Federation) were represented. This group was very helpful to coordinate activities and provide communication.

The airports can and have cooperated with the public health authorities in providing space for procedures such as exit screening. For airlines, they should include public health emergencies in their emergency response plan and practice this part of the plan as they practice the other parts.

As recommended in IATA’s Future of the Airline Industry report, partnership, dialogue and harmonization of measures between industry, government and other global bodies is crucial in mitigating the threat posed by communicable diseases to commercial aviation

The airlines should also endeavor to meet their local and/or national public health authorities to align their respective response plans. Experience has shown that it is too late during an outbreak to try and coordinate activities if the airlines do not know their counterparts in public health authorities.

The different airline departments involved in responding to an outbreak should follow IATA guidelines on communicable diseases. As communicable diseases evolve constantly, these guidelines are reviewed periodically and submitted to our main partners, WHO, ICAO and ACI, for comments and acceptance.

As recommended in IATA’s Future of the Airline Industry report, partnership, dialogue and harmonization of measures between industry, government and other global bodies is crucial in mitigating the threat posed by communicable diseases to commercial aviation.

IATA will play a crucial role in bringing these players to the table for the airline industry, in collaboration with its members. It’s one thing to be vigilant. It’s quite another to be prepared.

 

This article forms part of a series examining the challenges and opportunities facing the airline industry between now and 2035. These issues are explored in-depth in the ‘Future of the Airline Industry 2035’ report from IATA and the School of International Futures. For more information go to www.iata.org/flying2future

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