Establishing a regional disease surveillance network for emerging pathogens along the California-baja California border: Crossing disciplinary, organizational and international boundaries

The value of transnational disease surveillance in the prevention of regional and worldwide epidemics has increasingly been recognized as multi-country networks for infectious disease surveillance have emerged globally, particularly in conflict or low-resource settings. This paper presents a North American trans-border regional surveillance network established in the California (United States)/Baja California (Mexico) border region to enhance cross-border epidemiologic information exchange and surveillance for emerging pathogens. One Border One Health (OBOH) is a multidisciplinary initiative comprised of over 30 institutions from Mexico and 60 institutions from the United States, with participation from governmental, academic, non-profit, private and military sectors. Professionals with expertise in public health, human and animal medicine, ecology, biology, urban planning, wildlife and environmental health are working in concert rather than in traditionally siloed human, animal, and environmental health sectors. Despite the disparities between health systems, cultures, languages, socioeconomics, politics, animal management strategies, and ecosystems in the region, OBOH is building the infrastructure for a trans-border early warning system, while improving regional infectious disease surveillance capacity and educating a new cadre of students and professionals about One Health. Transnational One Health disease surveillance networks are as critical in North America as they are globally, and should be developed and sustained. Challenges include systematically operationalizing One Health without targeted funding, promoting data exchange, and maintaining equal understanding of One Health surveillance within the initiative as membership increases. This paper provides lessons learned and recommendations on initiating and sustaining cross-border, multidisciplinary, cross-sectoral surveillance, focusing on its strengths, challenges, and future directions.