International Health Regulation Implementation in French points of entry Marie-Line Sauvée Public Health Emergency Preparedness and Response Division Directorate General of Health

International Health Regulation French IHR National Focal Point Public health surveillance Institut Regional Health Agencies Régional focal point Ministry of Health Directorate General of Health Public Health Emergency Preparedness and Response Division IHR National focal Point Other ministries Ministry of internal affairs Ministry of foreign affairs Ministry of trade Ministry of transportation … CIC Interministerial crisis management commitee Public Health Agencies Alerts Prefects Governement’s local representatives WHO / IHREU / ECDC Alerts

International airports International ports Capacities required in all international ports and airports: Collect MDH, SSC or AGD on a routine basis Designate a contact point for exchanging with authorities Develop a public health contingency plan Develop a vector control program where needed Ensure safe environment International Health Regulation International ports and airports

Designated airports Designated ports Criteria for designation:  Mainland airports: more than 1 million international travelers  Overseas airports: more than international travelers  Mainland ports: according to their administrative status  Overseas ports: more than international travelers  1 designated port and airport in each French overseas territories  National criteria and list are established by French regulation International Health Regulation Designated points of entry

Designated airports Designated ports Capacities required in designated points of entry: Access to a medical service Area for the care for affected animals Space to interview suspect or affected persons Area for suspect conveyances Exercise every 2 years International Health Regulation Designated points of entry

Mandatory for each international ports and airports: o “Simplified” plan for point of entry o “Full” plan for designated point of entry Objectives: o Define how to implement PH measures listed in IHR articles 18 and 19 o Define SOP to manage PH alerts o Define roles and responsibilities of stakeholders Role of ministry of health: o National checklists to help local representatives monitoring IHR core capacities and developing action plans o National guidance to help local representatives developing PoE contingency plans International Health Regulation Points of entry contingency plan

Inspection system based on WHO recommendations: o National checklist based on WHO guidelines (French and English) Inspections conducted on board: o On request (to renew the SSC) o If a health problem is detected or suspected on board (MDH, previous certificate…) or if a ship has not a valid certificate o SSC can be used to grant “free pratique” No port health authorities in France: o Inspection will be perform by private companies o Accreditation systems under development o Development of a legal instrument to apply only one national tariff according to IHR article 41pecting ships (IHR, art 41) International Health Regulation Ship sanitation certificates Under development

Inspections conducted to check disinsection of aircrafts coming from: o Countries at risk for yellow fever and malaria (WHO International Travel and Health) o Countries at risk for dengue and chikungunya (French recommendations) No health officers in airport except: o 5 airports from overseas territories o 2 mainland airports Inspections based on WHO recommendations International Health Regulation Aircraft inspections

Information to travelers: o Conveyance operators and tourism operators must inform travelers about a public health risk at destination and explaining the protection measures (routine basis) o Public health risks are updated on a routine basis by the French MoH and published on the Ministry of Foreign Affairs website (“Recommendations to travelers”) o Obligation to write down on an international ticket the address of the Ministry of Foreign Affairs website Control of international certificate of yellow fever vaccination: o Yellow fever vaccination is mandatory in French Guyana (oversea territory) o Conveyance operators must check the validity of the certificate before embarking a traveler Specific provision for organizing contact tracing in case of alert o Conveyance operators must keep their list of passengers o Conveyance operators must collect passenger locator cards in case of alert International Health Regulation Additional measures in points of entry

France are still developing processes to :  Implement ship sanitation certificates  Apply only one tariff for health measures (IHR article 41)  Implement in a suitable and effective manner core capacities in overseas territories The full implementation of the International Health Regulation is an ongoing goal for France. France requests a second two-year extension for establishing national core capacities International Health Regulation Conclusion