The Ebola Virus And Aviation

| by Ruwantissa Abeyratne
( August 8, 2014, ontreal, !ri "an#a $uardian% At the ti&e o' writing, ()2 deaths had
been *on'ir&ed in $uinea, "iberia, !ierra "eone and +igeria due to Ebola, a&ong 1,11
re-orted *ases in those *ountries. /n addition, two A&eri*an &edi*al sta'' had also
been in'e*ted. and "iberia had de*lared a state o' e&ergen*y. The s-read o' the disease
'ro& 0est A'ri*a to other -arts o' A'ri*a is treated by the 0orld 1ealth 2rgani3ation
and *on*erned !tates as *riti*al. Ebola is a hu&an to hu&an disease *aused by the
Ebola virus where sy&-to&s a--ear between two days to three wee#s in a vi*ti&. The
sy&-to&s are 'ever, sore throat, heada*hes and bleeding. The virus s-reads by dire*t
*onta*t through bodily 'luids su*h as sweat, saliva or blood and it has not been
*on'ir&ed that it is *ontagious through airborne ve*tors that are usually trans&itted
through snee3ing and *oughing. Ebola *an be *ontained by isolating the a''e*ted
-erson while testing is done and by tra*#ing those who &ight be a''e*ted. There is no
#nown va**ine or *ure, and the &ortality rate in the *urrent outbrea# has been the
worst so 'ar 'or Ebola 4 around (0 -er *ent.
/&
age 5redit 6 7ailyTrust
/n ar*h, when a -erson living in 0inni-eg returned 'ro& "iberia to 5anada with
'ever, 5anadian health authorities went on high alert ta#ing -re*autions whi*h
in*luded addressing the ris# o' the s-read o' *o&&uni*able disease through aviation.
/n the aviation *onte8t, res-onsibility devolves u-on !tates to ta#e global &easures
and *oo-erate globally in *urbing *o&&uni*able diseases. Arti*le 14 o' the 5onvention
on /nternational 5ivil aviation (5hi*ago 5onvention% -rovides that ea*h !tate agrees to
ta#e e''e*tive &easures to -revent the s-read by &eans o' air navigation o' *holera,
ty-hus (e-ide&i*%, s&all-o8, yellow 'ever, -lague, and su*h other *o&&uni*able
diseases as the !tates shall 'ro& ti&e to ti&e de*ide to designate, and to that end
5ontra*ting !tates will #ee- in *lose *onsultation with the agen*ies *on*erned with
international regulations relating to sanitary &easures a--li*able to air*ra't. !u*h
*onsultation is re9uired to be without -re:udi*e to the a--li*ation o' any e8isting
international *onvention on the sub:e*t to whi*h the !tates &ay be -arties.
This -rovision i&-oses a res-onsibility on !tates to ta#e &easures in -reventing the
s-read o' disease through air trans-ort. /t is a very resilient -rovision that was
designed to address *o&&uni*able diseases -revalent in 1(44 but leaves the door o-en
to be in*lusive to &odern day diseases, two o' whi*h were !AR! and the Avian ;lu
-ande&i*. This -rovision also e8-li*itly devolves -ri&ary res-onsibility on !tates to
ta#e e''e*tive &easures to -revent airborne diseases in air*ra't and i&-li*itly re9uires
!tates to issue guidelines 'or airlines, by liaising with the international agen*ies
*on*erned. +on obstante, airlines have to 'a*e *ertain legal issues the&selves in ter&s
o' their *ondu*t. <ri&arily, airlines are e8-e*ted to *on'or& to a--li*able international
health regulations and the laws o' the *ountries in whi*h their air*ra't land.
;urther&ore, the airline owes its -assengers a duty o' *are to e8er*ise all *aution in
-rote*ting their rights, so that a blatant instan*e o' a -erson who loo#s si*#ly and
*oughs in*essantly at the *he*#4in *ounter *annot be ignored. 5o&&on law -rin*i-les
o' tort law vigorously distinguish between negligen*e, re*#lessness and wil'ul
blindness. 2' these ele&ents o' liability, wil'ul blindness is -arti*ularly relevant sin*e
it brings to bear the need 'or an airline to be vigilant in observing -assenger -ro'iles in
-otentially dangerous or threatening situations.
$ranted, Ebola is not #nown to be *ontagious but in'e*tious, whi*h would &ean that
the *han*es o' one -assenger *ontra*ting the disease by &erely sitting ne8t to another
who has a *ough &ight not be heavy. 1owever, one &ust not dis*ount the use o' toilets
in the air*ra't where one *ould *o&e into *onta*t with the bodily 'luids o' an in'e*ted
-erson.
2ne o' the &a:or -reo**u-ations o' the 0orld 1ealth 2rgani3ation (012% is to ensure
the international -revention o' disease. =uarantine regulations, whi*h was the 'irst
ste- toward this ai&, has a long history, having been introdu*ed during the tenth
5entury. 012 ado-ted /nternational 1ealth Regulations in 1(>1, the -hiloso-hy o'
whi*h was re*ogni3ed subse9uently as6 ?to -revent international s-read o' disease, and
in the *onte8t o' international travel, to do so with the &ini&u& o' in*onvenien*e to
the -assenger@. This re9uires international *ollaboration in the dete*tion, redu*tion or
eli&ination o' the sour*es 'ro& whi*h in'e*tion s-reads rather than atte&-ts to
-revent the introdu*tion o' disease by legalisti* barriers that over the years have
-roved to be ine''e*tive.
2' *ourse, the -ur-ose o' this -hiloso-hy will be de'eated i' individual !tates have no
willingness or the -oliti*al will to noti'y the outbrea# o' *o&&uni*able diseases to
012, -arti*ularly in the absen*e o' a &onitoring body, in*entives 'or !tates to noti'y
or san*tions. There'ore the -ree&inent obligation o' !tates is to ensure that the
outbrea# o' any *o&&uni*able disease is noti'ied in a &anner that would bene'it the
world and hel- -revent the s-read o' the disease a*ross national boundaries.
Regrettably, there have been instan*es re*orded where 012 re-orts that no new
instan*es o' a *o&&uni*able disease has been re*orded while the news &edia give
*ontrary in'or&ation si&ultaneously. 2ne o' the reasons addu*ed 'or the la*# o'
interest on the -art o' !tates to re-ort the in*iden*e o' *o&&uni*able diseases to a
world body su*h as 012 has been identi'ied as the la*# o' i&-ortan*e attributed to
/nternational 1ealth Regulations (/1R% by !tates who *onsider the regulations as an
obsolete reli*.
The international health di&ension o' -ubli* health events in aviation involves hu&an
rights issues as well. /nternational hu&an rights law has laid down two *riti*al as-e*ts
relating to -ubli* health6 that -rote*tion o' -ubli* health *onstitutes legiti&ate
grounds 'or li&iting hu&an rights in *ertain *ir*u&stan*es ( su*h as detention o'
-ersons or house arrest tanta&ount to 9uarantine e8er*ises would be :usti'ied in order
to *ontain a disease% A and individuals have an inherent right to health. /n this *onte8t
it is not only the !tate or nation that has an obligation to noti'y 012 o' *o&&uni*able
disease but the hu&an *on*erned as well, who has an abiding &oral and legal
obligation. /n 1(,>, 012 issued a -oli*y state&ent whi*h subsu&ed its -hiloso-hy on
health and hu&an rights whi*h stating6 ?The individual is obliged to noti'y the health
authorities when he is su''ering 'ro& a *o&&uni*able disease ( in*luding venereal
diseases% or has been e8-osed to in'e*tion, and &ust undergo e8a&ination, treat&ent,
surveillan*e, isolation or hos-itali3ation@. /n -arti*ular, obligatory isolation or
hos-itali3ation in su*h *ases *onstitutes a li&itation on 'reedo& o' &ove&ent and the
right to liberty and se*urity o' -erson.
/t is *riti*al 'or an evaluation o' the health and aeronauti*al i&-li*ations o' !AR! that
the ter& ?health@ be de'ined in *onte8t. 0hile the 012 5onstitution identi'ies as an
ob:e*tive o' the 2rgani3ation ?attain&ent o' the highest -ossible level o' health@, the
state o' health is de'ined as ?a state o' *o&-lete -hysi*al, &ental and so*ial well4being
and not &erely the absen*e o' disease or in'ir&ity@. /n an aeronauti*al -ers-e*tive,
this is a tough a*t to 'ollow, as international res-onsibility in the *arriage o' -ersons
e8tends only as 'ar as the obligation to -revent in:ury, wounding or death, and not to
the -hysi*al or &ental well4being o' a -erson.
1owever, this is one area where the /nternational 5ivil Aviation 2rgani3ation (/5A2%
has res-onded well, i' its res-onse to the !AR! *risis in 200) is any indi*ation. The
enor&ity o' the -roble& is brought to bear by the res-onse o' the /5A2 whi*h issued
guidelines on 2 ay 200) urging &e&ber !tates to6 i&-le&ent -re4boarding &edi*al
s*reening o' -assengers at *he*#4inA -rovide all in*o&ing -assengers with a detailed
in'or&ation lea'let on !AR!A i&-le&ent &edi*al s*reening o' -assengers arriving
dire*tly 'ro& or via a''e*ted areasA advise -ilots to radio ahead i' so&eone on board
e8hibits !AR! sy&-to&sA instru*t *rew on dealing with sus-e*ted !AR!4-atients in
'lightA and disin'e*t air*ra't on whi*h a sus-e*ted !AR!4-atient has travelled.
/n Buly this year, /5A2 issued a -ress release advising that the 2rgani3ation was
*ollaborating with 012 on the Ebola outbrea# in 0est A'ri*a. /5A2 a*ts through the
5oo-erative Arrange&ent 'or the <revention and anage&ent o' <ubli* 1ealth Events
in 5ivil Aviation (5A<!5A% whi*h is a global, *ollaborative arrange&ent between
/nternational 2rgani3ations, in*luding /5A2, 012, C+0T2, 0;<, /ATA, A5/, and
other bodies. 5A<!5A ai&s to i&-rove -re-aredness -lans in the aviation se*tor 'or
-ubli* health e&ergen*ies, or -otential e&ergen*ies, that *an arise 'ro&
*o&&uni*able diseases.
The e''orts o' the aviation *o&&unity notwithstanding, the ulti&ate res-onsibility lies
in the !tates a''e*ted to ta#e every &easure in arresting the s-read o' the disease by
ta#ing e''e*tive &easures o' 9uarantine, isolation and in'using a *ulture o' awareness
in their *o&&unities. The ulti&ate ai& should be to go to the root o' the -roble& and
atta*# it. 2' *ourse, aviation *an hel- in this role by *arrying by air &u*h needed
&edi*al sta'', &edi*ation and e9ui-&ent swi'tly and e''i*iently.
The author is an aviation *onsultant who is a 'or&er senior o''i*ial at the /nternational
5ivil Aviation 2rgani3ation
<osted by Thava&