WHO Backs Dual-Format Ship Health Documents as Digital Systems Lag
WHO is pressing States Parties to keep Ship Declaration of Health and Ship Sanitation Certificates available in both digital and non-digital formats while maritime health systems continue their transition to electronic documentation. The guidance arrives after the 2024 amendments to the International Health Regulations (2005) took effect for most States Parties on 19 September 2025, creating a legal basis for either format as long as authenticity can be verified.
The practical message is immediate: digital readiness is uneven, and the paper trail still matters at sea.
Article 35 of the amended IHR now permits health documents in digital or non-digital form, but only when the document’s authenticity can be ascertained. That requirement is more than administrative fine print. For border health authorities, port officials, shipmasters, ship owners, and ship agents, the credibility of a ship’s health paperwork affects how quickly a vessel can be cleared, whether public health measures are escalated, and whether unnecessary disruption is introduced into international traffic. In a setting where ships move between legal systems, ports, and technical infrastructures, a document that cannot be readily authenticated loses its value even if it exists in electronic form.
Port Health Authority Gaps Keep Paper Documents Relevant
WHO’s advice reflects a gap between regulatory intent and operational reality. Many States Parties still lack the capacity, systems, or interoperability arrangements needed to issue and verify ship-related digital health documents consistently. Some authorities can receive electronic records but cannot authenticate them reliably. Others may have different national platforms that do not communicate well with one another. In that environment, a digital document can become a barrier instead of a simplification if the receiving port cannot confirm its validity without delay.
This is where the non-digital format retains a clinical and operational function. By keeping SDHs and SSCs available on paper alongside any digital version, authorities reduce the risk of document failure at the point of arrival. The result is not redundancy for its own sake. It is continuity. Maritime traffic depends on documents that can be reviewed in real time by officials at any port of call, regardless of the maturity of local digital infrastructure.
The policy also speaks to equity in global health administration. A system that assumes universal digital capacity before that capacity exists can widen the divide between well-resourced and resource-limited States Parties. For ships, that divide can translate into delays, repeated inspections, or conflicting expectations about what constitutes valid health documentation. For ports, it can produce avoidable friction just when public health authorities need efficient information exchange.
Maritime Digitization Cannot Outrun Authentication
Since 1 January 2024, the Convention on Facilitation of International Maritime Traffic has required public authorities to establish, maintain, and use Maritime Single Window systems for electronic submission of information related to a ship’s arrival, stay, and departure. That requirement points toward a broader digital future for shipping, but WHO’s position makes clear that digitization cannot be treated as complete until verification keeps pace with issuance.
A ship document is only useful if the receiving authority trusts it.
That is especially true for health documents, where the stakes include the detection of potential public health risks and the prevention of unnecessary interference with travel and trade. A shipmaster completing an SDH and a competent authority issuing an SSC both need a process that preserves the document’s legal standing across borders. If a port cannot check authenticity, the digital version may slow clearance rather than accelerate it. WHO’s guidance therefore favors a dual-track approach: digital where possible, paper where necessary, and both formats available during the transition.
The recommendation extends to any authority with responsibilities related to ship documentation, not only public health offices. Border health agencies, port authorities, and other officials involved in enforcement all have a role in making sure the documentation can be accessed and reviewed. Ship owners and ship agents are also included in the call, since operational compliance depends on the actors who manage the vessel’s paperwork before arrival. In practice, that means keeping the non-digital form available at all times, even when a digital copy exists.
Continuity of Maritime Operations Remains the Central Goal
The driving concern is to avoid unnecessary interference with international traffic while digital systems mature. Maritime operations depend on predictable clearance procedures, and the health documentation attached to a vessel can shape those procedures quickly. If one port accepts a digital record and another cannot verify it, the ship may face uneven treatment despite carrying the same health information. WHO’s advice seeks to lower that risk by ensuring that both formats remain accessible during the transition period.
There is also a trust dimension. Mutual confidence among States Parties depends on shared rules that are workable across different technical environments. When a paper SSC or SDH accompanies the digital version, it provides a fallback that can be reviewed immediately if electronic verification is not possible. That redundancy supports both continuity and credibility, two requirements that maritime health systems cannot afford to separate.
For clinicians, public health officials, and policy leaders, the document is a reminder that digital transformation in health is not just a software problem. It is a systems problem involving legal standards, verification capacity, interoperability, and the operational realities of cross-border transport. In maritime settings, the pace of digitization must match the ability of ports and authorities to authenticate what they receive.
WHO’s position does not reject digital documentation. It sets a condition for safe adoption: do not abandon non-digital ship health documents until digital verification is reliable enough to preserve continuity, trust, and lawful port operations. The unresolved issue is not whether shipping will become more digital, but how quickly States Parties can build the authentication capacity needed to make digital documents function across every port of call without disruption.