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ISDS 2012 Conference Abstracts

A Binational Model of Collaboration for Enhancing
Cross-border ID Surveillance
Kristine Ortwine*2, 1, Karen Ferran1 and Esmeralda Iniguez-Stevens1

1Early Warning Infectious Disease Surveillance, California Department of Public Health, San Diego, CA, USA; 2San Diego State
Graduate School of Public Health, San Diego, CA, USA

Objective
The purpose of this demonstration is to describe the cross-border

collaborative processes used for the development of a transparent
methodology to identify and prioritize zoonotic infectious disease
agents in the California-Baja California border region.

Introduction
International borders present unique challenges for the surveillance

of infectious disease.  Border communities represent locations with
vast differences in cultures and languages, governing institutions,
healthcare access, and priorities for the collection and surveillance
of disease data. Pathogens and the health and security risks they cre-
ate do not respect geographical and political boundaries.  However,
the organizations responsible for the surveillance and control of these
agents must function within the borders of their respective govern-
ments. One Border One Health (OBOH) is a binational, multidisci-
plinary initiative aimed at engaging partners in the US and Mexico to
identify and implement methods for successful communication and
collaboration to enhance health capacity and disease surveillance
within the border region. The advancements of international initia-
tives such as OBOH will help to develop the types of multi-country
networks necessary for the effective monitoring of disease patterns
and risks.

Methods
One Border One Health Surveillance Committee participants rep-

resent multi-disciplinary professionals working together for the ad-
vancement of One Health principles in the California/Baja California
border region. This showcase documents the identification and pri-
oritization of zoonotic infectious disease agents along the US-Mex-
ico border, by use of a transparent methodology which engaged
public and private partners from both countries.  Preliminary research
and input from collaborators in government, academic, and private
sectors in the US and Mexico allowed for review and discussion of
current methodologies available for prioritizing infectious agents.
The DISCONTOOLS Work Package 2 Prioritization Scoring Model
was selected as the basis for scoring and weighting various zoonotic
diseases of concern within border region.  Subject matter experts were
then asked to review and score an initial list of diseases, in order to

produce a final ranked list of pathogens. The intent is that these pri-
oritized pathogens will be used by government agencies to make in-
formed decisions, integrating priorities from both nations with
regards to infectious disease surveillance. This collaboration provides
insight into the binational cooperation needed for the selection of dis-
eases to be considered in a regional, integrated disease surveillance
system. To the authors’ knowledge this is the first transparent scien-
tific-based approach to pathogen prioritization in the US-Mexico bor-
der region.

Conclusions
OBOH is the first binational regional network of its kind along the

US-Mexico border recognizing the interconnectivity between human,
animal, and environmental health. Given the limited resources in the
current economic climate, the use of regional integrated surveillance
systems provide an opportunity to protect and improve border health
and security by moving away from species-specific surveillance pro-
grams. The process showcased here for the transparent review and
prioritization of pathogens along the California-Baja California bor-
der can be used as a model along the entire US-Mexico Border. The
ultimate aim is to protect border communities through the creation
of a binational, early warning surveillance system which would allow
for actionable and timely interventions to limit emergence, mitigate
spread, provide gap analysis, and enhance prevention and control for
several emergent and re-emergent diseases.  Ultimately, this will de-
crease negative health and environmental impacts while improving
agricultural and economic outcomes in both nations. However, ob-
stacles such as continued sustainability, identification of new multi-
disciplinary collaborators, cooperation between government agencies,
and identifying funding for advancement of integrated regional sur-
veillance systems remain challenges.

Keywords
One Health; disease surveillance; cross-border collaborative

*Kristine Ortwine
E-mail: kristine.ortwine@cdph.ca.gov

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 5(1):e206, 2013