Tackling emerging and re-emerging health threats through cross-border zoning and joint multi-country action

Abstract

Background. The weak disease-surveillance systems between countries require the establishment of harmonised consensus-based collaborations and the implementation of cross-border surveillance approaches.

Objective. To tackle public health emergency threats using cross-border zoning and joint multi-country collaboration.

Methods. Under the Southern Africa TB Health Systems Support project, 25 cross-border zones were identified using defined zoning criteria. Established zones were led by multisectorial zonal committees with defined roles and responsibilities. 

Results. Between November 2017 and January 2020, 13 (52%) of the 25 cross-border zones were operationalised. Thirteen joint work-plans were developed, and are at different stages of implementation. Six (75%) of 8 follow-up meetings that were due were conducted. Thirteen tabletop simulation exercises and donning and doffing demonstrations were conducted. Two field simulation exercises were conducted to test preparedness in a close-to-real-life situation. Thirteen communication channels were established. Thirty zonal members were trained in threats hazards identification and risk assessment (THIRA), and 3 zones subsequently identified, and their hazards prioritised. Joint responses for cholera, anthrax, foot and mouth disease and African swine fever outbreaks were conducted.

Conclusion. The use of cross-border zoning led by multisectorial cross-border committees is an effective way of ensuring heightened preparedness and response to epidemics and events of public health concern at the local level.