Ships sail from country to country where different hygiene standards and rules for controlling diseases exist. In the European Union, a common policy for dealing with health threats related to ships is needed. Ship traffic at European ports continually increases. In 2010, 1.9 million cargo ships visits were recorded in 1200 seaports in the 25 maritime European Union Member States. Approximately 390 million ferry passengers passed through European Union Member State ports in 2009, 6.2 million Europeans cruised in 2011 and about 570,000 European seafarers were employed in cruise ships. In 2011, 45 cruise lines with 198 cruise ships operated in Europe. The European market has grown by 41% over the past three years and has more than doubled over the last ten. 

To address the above mentioned issues the European Commission funded two European projects:
SHIPSAN  and SHIPSAN TRAINET (http://trainet.shipsan.eu) from 2006 until 2011. Figure 1 presents the main deliverables produced under each project.

Under the SHIPSAN project (2006-2008), a survey was conducted and demonstrated that many different authorities (up to five) were responsible for conducting inspections within the same country without always having clearly defined roles and responsibilities. Lack of communication, knowledge and training in relation to hygiene inspections from competent authorities was observed. The practices of hygiene inspections on board ships varied between European countries and many times and within the same country or even within the same port. Finally, difficulties occurred in Europe in the implementation of the International Health Regulations (2005) and issuance of Ship Sanitation Certificates.

SHIPSAN TRAINET (2008-2011) then developed and implemented a training programme, the European Manual for hygiene standards and communicable diseases surveillance on passenger ships and a communication network.
In February 2013, the new EU SHIPSAN ACT Joint Action started addressing health issues in maritime transport. A “Joint Action” was introduced in 2008 by European Commission as a new financial mechanism under the Health Programme 2008-2013 to ensure the support to actions with European Union added value, aiming to reach sustainability and take-up by the European Union Member States. SHIPSAN activities are now implemented not as a project, but in the framework of a European Joint Action.

What are the differences between the SHIPSAN, SHIPSAN TRAINET projects and the EU SHIPSAN ACT Joint Action?

	SHIPSAN & SHIPSAN TRAINET projects	EU SHIPSAN ACT Joint Action
Type of vessel	Only Passenger Ships	All types of ships (passenger, cargo ships, inland navigation, fishing vessels)
Objective	Communicable diseases	All health threats including chemical and radiological agents
	Occupational health was not included in the objectives	Occupational health risk assessment tool for cargo ships
Inspections	Pilot inspections with trainers for 6 months	•      Proposal document for auditing of inspections, grading system and target factor for inspections prioritization •      Framework of permanent implementation of the inspection programme •      During the 3rd year short-notice inspections without trainers
Training	Training on the SHIPSAN Manual	•      Training on IHR Sanitation Certificates •      Training material on risk assessment and dealing with chemical/radiological events on ships •     Support to National training courses
Surveillance	Communication network	SHIPSAN INFORMATION SYSTEM