Handbook for public health capacity-building at ground crossings and cross-border collaboration

Abstract

Rationale: The International Health Regulations 2005 (IHR) stipulate that States Parties should designate airport(s) and port(s) that will meet the core capacities, as laid out in Annex 1 of the IHR. However, the regulations only “suggest” that a State Party may designate ground crossings “where justified for public health reasons” (Articles 19, 20 and 21) and “encourage” neighbouring countries to cooperate by entering into bilateral or multilateral agreements/arrangements concerning prevention or control of the international transmission of disease, or by joint designation for developing IHR ports of entry (POE) capacities. Ground crossings are predominantly characterized by more complex and varied environments than settings at other POE such as airports and seaports. Ground crossings often represent larger cross-border communities with strong family and commercial ties, where travellers may frequently – even daily – traverse a porous border. Persons crossing these borders may use a large variety of transport ranging from trains, trucks (lorries), buses, automobiles, motorcycles or bicycles to animals or even passing through on foot. Depending on the populations served by ground crossings, the volume of traffic may fluctuate or vary from tens of thousands to fewer than 50 persons per day. The infrastructure and resources available to competent authorities at a ground crossing can differ widely. Some crossings have sustained electricity and large, modern technologically-equipped facilities with sufficient staffing, while others may consist of only a simple makeshift gate intermittently staffed by one or two persons along a rural frontier with no electricity or cell phone connections, and yet others may be no more than a known location on an open road or footpath were the land changes from one country to another. Given extensive terrestrial frontiers and geographical constraints, ground crossings may be both formal or informal, the latter far outnumbering the former. Finding sufficient technical staff for such crossings is a significant challenge. The variety of governmental and nongovernmental stakeholders concerned with ground crossings includes authorities for border policy and regulations for commerce, immigration, security, animal health. This range of stakeholders, when coupled with the differing geographical, sociodemographic, infrastructure and resource factors, often presents challenges in developing the necessary capacities and collaborative partnerships for coordination and action within countries and across borders...