Decisions of the 42nd Coordinative Advisory Aeromedical Council (CAAC)

On November 27-28, 2024, the Interstate Aviation Committee (IAC) held the 42nd session of the Coordinative Advisory Aeromedical Council (CAAC) which was dedicated to the problems of coordinating and harmonizing interstate and interdepartmental cooperation between the aviation health care system of the States parties to the Agreement on Civil Aviation and Use of Airspace (Agreement) and ways to address them considering Standards and Recommended Practices (SARPS) of the International Civil Aviation Organization (ICAO) and the Regulations of the World Health Organization (WHO).

Based on the results of the work of IAC CAAC, the following decisions were made:

1. To approve the areas of activity of the IAC Coordinative Advisory Aeromedical Council. 

2. In its activities, IAC CAAC will continue active cooperation with the States parties to the Agreement, CIS Healthcare Cooperation Council, other relevant organizations and interstate structures on the implementation of issues of medical, sanitary, hygienic and anti-epidemic support for civil, state and experimental aviation, coordination and their implementation including draft regulatory documents prepared by the IAC, approved and recommended for implementation by the Council on Aviation and Use of Airspace, as well as by the Working Group under the Council for Cooperation in the field of healthcare of the CIS Executive Committee. 

3. Intensify the exchange of information and cooperation between public health organizations and the aviation sector, between civil and state aviation. 

4. Intensify the activities of aviation medicine for fatigue risk management, professional and psychological selection and support, assessment of the work intensity of pilots, considering specific types of aircraft, combined with a daily assessment of the functional state of the nervous and cardiovascular systems.

5. IAC Aviation Medicine Department will continue to work on: coordinating and harmonizing issues of medical and sanitary safety and prevention of public health hazards in civil aviation (CAPSCA); assessing the state of preparedness of the GA of the States Parties to the Agreement and designated airports in prevention of public health hazards; implementing and verifying Civil Aviation Preparedness Plans for States in case of emergency in the field of public health; organizing technical assistance tours in states offline and further support of readiness of public health corridors (iPack). 

6. Support the initiatives carried out within the framework of the ICAO-IAC cooperation on CAPSCA Project implementation and to continue the exchange of information and interaction between public health organizations, aviation organizations of the Commonwealth of Independent States (CIS, Commonwealth), ICAO and WHO on improving the planning of States' preparedness for aviation emergencies related to healthcare. Initiate a proposal on the accession of the States of the Agreement (Russia, Turkmenistan) to the CAPSCA Program at the Council on Aviation and Use of Airspace and the CIS Executive Committee.

7. Contribute to maintaining the interaction of the Commonwealth States and regional CAPSCA networks through the development of electronic tools (expert checklists and templates, as well as e-learning activities, virtual CAPSCA assessments, technical assistance visits, self-assessments, etc.). 

8. Promote the adoption of the Agreement in the contracting States as a basis for the preparation of national Plans, a consolidated comprehensive plan of organizational and sanitary anti-epidemic measures to prevent public health hazards at air transport facilities. Assist the States parties to the Agreement in ensuring compliance with ICAO Standards and Recommended Practices and WHO Regulations. 

9. Contact the airport authorities of the States parties to the Agreement on the need to organize training at the International Rescue Training Center (IRT center) in order to prepare medical personnel of international airports of the Commonwealth states on medical and sanitary safety, prevention of hazards in the field of public health and emergencies in civil aviation.

10. Coordinate the organization and training of technical experts for the States Parties to the Agreement jointly with the ICAO European Bureau for CAPSCA program implementation on the basis of the IRTCentre of the Republic of Belarus. 

11. Continue to participate in the meetings of the Regional Expert Group, CAPSCA EUR Conference and CAPSCA Global Symposium in order to implement CAPSCA global work, CAPSCA EUR regional work. 

12. Recognize the expediency of improving cooperation with public organizations (AACMEEM of Russia, AVAM) and the IRTCentre of the Republic of Belarus on medical flight safety, prevention of hazards in the field of public health in civil aviation (CAPSCA) and assistance on board the aircraft (doctor on board).

13. IAC CAAC experts consider it necessary and relevant to develop and adopt a unified and standardized Protocol for the organization and provision of first aid on board an aircraft. 

14. Appeal to the Ministry of Health of the Russian Federation, Ministry of Health of Belarus, Ministry of Emergency Situations of Russia and Ministry of Emergency Situations of Belarus with a proposal to involve the Centers of the Federal State Budgetary Institution "NMHTS named after N.I. Pirogov" of the Russian Ministry of Health of the Russian Federation, Federal State Public Enterprise Nikiforov’s All-Russian Center for Emergency and Radiation Medicine, Federal State Public Institution "State Central Airmobile Rescue Team of the Russian Emergencies Ministry" ("Centrospas"), IRT center of the Ministry of Emergency Situations of Belarus in the joint development, within the framework of the Union State, of regulatory documents on assistance on board the aircraft, standard training programs for flight and cabin crew members to prevent public health hazards and provide assistance on board the aircraft.

15. In order to improve the system of medical examination of aviation personnel, considering ICAO Standards and Recommended Practices (Annex 1 "Issuance of certificates to Aviation personnel", "Manual on Aviation Medicine" DOS 8984-AN/895) and international experience, IAC Aviation Medicine Department, with the involvement of experts from the States Parties to the Agreement, should analyze regulatory documents for further development of matrix Aviation Regulations "Requirements for health fitness of aviation specialists for determining their pilot aptitude, air traffic control work, flight attendant work, training at educational institutions of civil aviation and obtain (renew) a Medical certificate" of civil aviation specialists of the States parties to the Agreement and submit for approval by the Council on Aviation and Use of Airspace, followed by information and advisory assistance to aviation authorities and the Ministry of Health of the States parties to the Agreement on the coordination of amendments and implementation in the States.

16. Finalize and submit for approval professional standards and regulations in the specialty "Aviation and Space Medicine Physician" to the Ministry of Labor and Social Protection of the Russian Federation and the Ministry of Health of the Russian Federation. 

17. In the member States of the Agreement, the experts of the IAC CAAC recommend the implementation of the "Doctor on board the Aircraft" Program as an important component of the aviation medical safety process. This system requires further improvement, unification and standardization, considering ICAO SARPs, world practice, modern clinical medicine capabilities and automation for its widespread practical application (using objective automated analysis tools).

18. In order to consolidate and harmonize regulatory legal documents, analyze the regulatory framework for medical, sanitary, hygienic and anti-epidemic support for civil aviation in the States parties to the Agreement and submit proposals for their further harmonization to the Council on Aviation and Use of Airspace and CIS Healthcare Cooperation Council. 

19. Сonsider the possibility of creating conditions for the formation of a unified medical information space for the aviation medical units (institutions) of the States parties to the Agreement.

20. In order to increase the effectiveness of medical flight safety and the need to standardize aviation medicine training for aviation medical specialists and psychologists from the Commonwealth countries, contact educational institutions (RMAPO RF, First Moscow State Medical University named after I.M. Sechenov, Military Medical Academy, Federal State Budgetary Scientific Institution “Izmerov Research Institute of Occupational Health) on the possibility of developing a list of advanced training cycles for aviation doctors and psychologists. Subsequently, it should be submitted to the Council on Aviation and Use of Airspace (aviation authorities of the States parties to the Agreement) and CIS Healthcare Cooperation Council for consideration and adoption. 

21. The experts of the IAC CAAC reviewed and recommended updating for further application in the States parties to the Agreement "The Standard Plan of civil Aviation (state) preparedness for an emergency in the field of public health of international importance" and "Methodological recommendations for the organization and conduct of sanitary and antiepidemic (preventive) measures in case of identification of a patient (suspected infection, corpse) with an infectious disease that represents a public health emergency, of international importance during flights of civil aviation aircraft", "Standard labor protection instruction on for those working in accident investigation commissions".

22. In order to enhance cooperation to prepare concrete proposals for addressing joint coordinated issues aimed at preserving and strengthening the health of aviation personnel and prolonging their professional longevity, to hold a meeting of an Interdepartmental Working Group in consolidation with the Association of aerospace, marine, extreme and Environmental Medicine of Russia (hereinafter – Association) on issues of cooperation in solving the tasks of medical and sanitary-epidemiological support of flights of state, experimental and civil aviation aircraft, update the adopted Programs and Work Plan. Determine the next meeting of the working group and the Presidium of the Association for April 2025. 

23. Approve changes in the composition of the IAC CAAC, according to the proposals received from the members of the Coordinating Council.

24. Hold a regular CAAC meeting n the Republic of Tajikistan in May-June 2025 on the topic: "The role and objectives of aviation medicine in modern realities".