ICAO and the World Health Organization


The French Government initiated and hosted in 1851 the first of 14 International Sanitary Conferences to standardize international quarantine regulations, against the spread of cholera, plague, and yellow fever. During the 19th century, however, lengthy debates focused mainly on cholera. Thus, the world had to wait till 1892 to see the first International Sanitary Convention (restricted to cholera) to be adopted, at the 7th International Sanitary Conference in Venice, Italy. Further conferences came up with additional Sanitary Conventions which were consolidated at the 11th Conference in Paris in 1903 and later revised in 1926.


Also at this 11th Conference in 1903, it was agreed that a permanent health bureau should be created; at a meeting of government representatives in Rome, Italy in 1907, the final decision was taken to set up the Office International  d’Hygiène Publique (OIHP, which was the forerunner of the World Health Organization), which had no authority to do field work within a particular country, but developed an effective organization for disseminating knowledge on communicable diseases and their control.


The International Sanitary Bureau, precursor of the Pan American Health Organization (PAHO), was established by the First General International Sanitary Convention of the American Republics held in Washington, DC., in 1902. In 1923, the International Sanitary Bureau became the Pan American Sanitary Bureau and in November 1924 the Pan American Sanitary Code was approved and signed in Havana, Cuba. This instrument, which was ratified as an international convention by all 21 participating Members States in succeeding years, became the basis for the development of the Pan American Sanitary Bureau as an international institution, with resources made available through the apportionment of its budget among these States according to the scale of assessments established within the Pan American system.


Label issued for the 1st International Congress on Sanitary Aviation (actually held from 14 to 20 May)

The development of aviation in the 1930s had greatly increased the rapidity of transport (passengers, freight and mail) between countries and brought various parts of the word closer together as regards time; at the same time, the danger of aircraft conveying diseases was foreseen by the health authorities with the result that the first International Congress on Sanitary Aviation (Congrès international de l’aviation sanitaire) was held in Paris, France from 14 to 20 May 1929 and that the first International Sanitary Convention for Aerial Navigation was signed at The Hague on 12 April 1933 (without a conference) and came into force on 1 August 1935 to protect communities against diseases liable to be imported by aircraft and to protect flying personnel against diseases due to flying; it contained numerous regulations consisting of measures to prevent the spread of plague, cholera, yellow fever, typhus and smallpox. This Convention was amended in Washington on 15 December 1944 and open for signature; it came into force on 15 January 1945. The protocol signed on 23 April 1946 prolonged the 1944 Convention. Note that the second of these Congresses on Sanitary Aviation was held in Madrid from 1 to 5 June 1933 and the third in Brussels from 10 to 15 June 1935.The last International Sanitary Conference was held in Paris in 1938 with a very limited scope; these Conferences provided a spirit of international cooperation and a forum for medical administrators and researchers to discuss not only cholera, but also other communicable diseases.


7 April 1964

United Arab Republic

World Health Day

The Second World War was to prove a catalyst for international health. The Constitution of the World Health Organization (WHO) was approved at the International Health Conference held in New York from 19 June to 22 July 1946; created by the Conference, the WHO Interim Commission was to exist until the 26th of the 61 member states (which attended the New York Conference in 1946) deposited their formal instrument of acceptance with the Secretary-General of the United Nations. The WHO Constitution came into force on 7 April 1948; 7 April is now marked as World Health Day each year. The functions of the OIHP were gradually taken over by the WHO in period of 1946-1948. The International Sanitary Convention for Aerial Navigation of 1944 was transferred to the Interim Commission of WHO.


WHO's emblem consisting of the United Nations symbol surmounted by a staff with a snake coiling around it, which has long been a symbol of medicine and the medical profession.

ICAO and WHO were soon destined to cooperate. The necessary health precautions must be taken in such a way as not to delay international air transport operations; this matter was considered at the work of PICAO’s Division on Facilitation (FAL), which met for the first time in Montreal from 24 January to 2 February 1946, and it was expected to develop more specific health provisions for inclusion in the FAL standards. Moreover, during its first session held from 15 to 23 January 1946, PICAO’s Division on Personnel Licensing (PEL), which was given the responsibility for establishing standards for the licensing of operational and mechanical personnel, recommended the establishment of a Medical Division at ICAO. Thus, considerable thoughts were given at ICAO to the means by which medical problems of concern to aviation should be dealt with and the Air Navigation Committee decided to recommend the appointment to the Secretariat of an expert in aviation medicine (i.e. Medical Advisor), so that ICAO’s aviation medical programme could start to address problems of particular aeromedical character for flying personnel and problems of sanitation on aerodromes.


A Medical Advisor, Dr. Fanz E. de Tavel, was appointed to ICAO in 1949. He represented the Organization on various Committees and Assemblies held by WHO and remained with ICAO until 1961 for a transfer to WHO. The Medical Section (later renamed Aviation Medicine Section) was officially created at ICAO in 1959. Many of the problems handled by ICAO technical Divisions had medical problems; they were not so distinct and separable from other aspects of aviation. As WHO adopted new sanitary regulations, ICAO standards were revised to include the new medical standards of the public health requirements.


Two Annexes to the Chicago Convention specifically deal with aviation medicine:

1. Annex 1: Personnel Licensing (Chapter 1: Medical Fitness and Chapter 6: Medical Provisions for Licensing); and

2. Annex 13: Aircraft Accident and Incident Investigation (Chapter 5: Investigation: Autopsy Examination, Medical Examination).

The medical provisions in Annex 1 are supported by guidance material developed in the Manual of Civil Aviation Medicine. This manual gives background information, explains the requirements in detail, gives guidance on how to examine applicants and how to investigate various medical conditions, and gives advice on how to interpret pathological findings in the context of an aeromedical disposition.


Although discussed in the early days of PICAO and ICAO, no formal agreement was felt necessary to establish the necessary cooperation between ICAO and WHO. The primary problem which ICAO and WHO had in common at that time was the preparation and application of a revised International Sanitary Convention for Aerial Navigation to preserve the chief benefit of aviation (i.e. speed) by eliminating unnecessary forms and procedures which unduly delay aircraft and their passengers, while preventing the spread of diseases by international air transport. Revised International Sanitary Regulations were adopted by WHO in May 1951; the 22nd WHO Assembly (held in 1969) adopted, revised and consolidated the International Sanitary Regulations, which were renamed the International Health Regulations. As the magnitude of air transport operations grew, continued attention was given by WHO to public health requirements in aviation and a Guide to Hygiene and Sanitation in Aviation was first published in 1960 and updated regularly thereafter. This guide has the ultimate goal of assisting all types of airport and aircraft operators and all other responsible bodies in achieving high standards of hygiene and sanitation, to protect travellers and crews engaged in air transport.


PAHO Emblem

The XII Pan American Sanitary Conference, held in Caracas in 1947, created the Pan American Sanitary Organization (PASO) and designated the Pan American Sanitary Bureau as its operating agency or Secretariat. This Conference also approved the general terms of an agreement with the WHO; on 24 May 1949, an agreement was signed between WHO and PASO by which the latter Organization would serve as the Regional Office for the Americas of the World Health Organization. The XV Pan American Sanitary Conference, held in San Juan, Puerto Rico, in 1958, modified the name of the Pan American Sanitary Organization to the Pan American Health Organization (PAHO; in Spanish: Organización Panamericana de la Salud, OPS), which now provides technical cooperation and mobilizes partnerships to improve health and quality of life in the countries of the Americas. PAHO is the specialized health agency of the Inter-American System.


ICAO developed a set of protective measures for use at international airports to prevent the spread of Severe Acute Respiratory Syndrome (SARS). The measures, based on guidelines issued by the WHO, consist of specific procedures for screening of passengers at departure and on arrival, and for screening of airports workers. Included is information to all passengers about SARS and guidance on handling of suspected cases on board and at destination. The set of measures and the evaluation criteria were finalized during a meeting held in Singapore from 2 to 4 June 2003.


Public health events are often multi-sectoral and international in nature, and should therefore be managed at several different levels: operational, national, regional and global. While Article 14 of the Chicago Convention requires that Member States take measures to prevent the spread of communicable disease and ICAO Assembly Resolution A35-12 (35th Session of the Assembly, 28 September to 8 October 2004) states that the protection of the health of passengers and crews on international flights is an integral element of safe air travel, ICAO expanded during 2006 its role in assisting States to mitigate the risk from pandemic disease, developing the work that was initiated for the pandemic influenza in 2005. ICAO coordinated an international effort to write guidelines for States. The Air Navigation Bureau and the Technical Co-operation Bureau worked closely together, in cooperation with the Regional Offices, and set up a programme entitled Cooperative Arrangement for Preventing the Spread of Communicable Diseases through Air Travel (CAPSCA).


Emblem of the CAPSCA Programme

CAPSCA is a global, collaborative programme established between many international organizations, including ICAO, World Health Organization (WHO), United Nations World Tourism Organization (UNWTO), International Air Transport Association (IATA), Airports Council International (ACI), International Federation of Air Line Pilots' Associations (IFALPA), etc. to improve preparedness planning and response to public health events (not only communicable disease) that affect the aviation sector, such as an influenza pandemic or a nuclear power-plant accident. ICAO has worked with States and the afore-mentioned partners to develop relevant provisions in a number of Annexes to the Chicago Convention. Guidance material has been produced to support these provisions.


The title of the CAPSCA programme was changed in 2013 to the Collaborative Arrangement for the Prevention and Management of Public Health Events in Civil Aviation, while retaining the same acronym, to reflect the increased scope of the programme beyond that of communicable disease, for example, radio-nuclear accidents or chemical events.



First International Congress on Sanitary Aviation – Postcard front and back.


France – 18 June 1929 - First International Congress on Sanitary Aviation,

with label and hand-stamp related to the Congress.

On this occasion, Michel Détroyat carried out a special flight from Orly to Reims with a Morane-Saulnier MS.230. 35 letters were transported, including this one autographed by Détroyat.

In June 1927, Michel Détroyat joined Morane-Saulnier as second pilot and instructor; in 1928, he became test pilot; Détroyat took part in many competitions, exhibitions and raids.


First International Congress on Sanitary Aviation held in Paris from 14 to 29 May 1929.

Official report of the discussions.


On 17 June 1951, France issued a stamp commemorating the centenary of the School of Application of Health Service at Val-de-Grâce, Paris; it shows the pictures of eminent military doctors and chemists/pharmacists, i.e. Robert Picqué, François-Zakarie Roussin (1827-1894) and Jean-Antoine Villemin (1827-1892).


Service cover sent from WHO to ICAO – Postmarked on 18 March 1958.


Service cover sent from ICAO to WHO – Postmarked on 19 May 1958.

Early unofficial ICAO emblem. Metered stamp.


1958 – WHO slogan – 10th anniversary.


Cover sent from ICAO’s Regional Office in Paris to WHO in Geneva – Postmarked on 23 April 1959.

Early unofficial ICAO emblem. Metered stamp.


Argentina – Second Thematic Philatelic Exhibition (TEMEX ’60) held in Buenos Aires from 4 from 9 December 1960. During this exhibition, a total of 12 covers were released paying tribute to the United Nations, its Programmes and Specialized Agencies; all covers are similar, except for the emblem, the colors of the UN Buildings in New York and the date of release. These covers were issued on different dates ranging from 4 to 9 December 1960; the above cover related to WMO was dated 7 December 1960.


Service cover sent by ICAO to WHO Liaison Office in New York. 

Postmarked on 16 March 1960. Red meter and slogan showing ICAO’s early emblem.


Service cover sent by the Pan American Health Organization (PAHO) to ICAO.

Postmarked on 7 December 1970.  


Service cover sent by WMO to ICAO. Postmarked on 12 June 1979.

Red meter and slogan showing WHO’s emblem.


Commercial cover sent by WMO to ICAO. Postmarked on 13 December 1993.

Postage stamps issued by Switzerland for WHO on 13 February 1975.


Official service cover sent by the Malaysian Government to ICAO Medical Section.

Postmarked on 24 April 1975. With a Kuala Lumpur machine slogan cancel.


Service cover sent from the UN to ICAO. Slogan celebrating the World Health Day (7 April).

Postmark dated 29 April 1991.