Overview

The Early Warning Infectious Disease Surveillance (EWIDS) program is a Trinational collaborative effort to improve detection, identification, monitoring, reporting and response to natural or intentional cross-border infectious disease outbreaks and public health threats.

EWIDS consists of two separate yet complimentary initiatives: 1) Enhance cross-border epidemiology and infectious disease surveillance capacities among the twenty U.S. States bordering Canada and Mexico, and 2) Provide EWIDS-specific funds to the six northern Mexican states bordering the United States, through the U.S.-Mexico Border Health Commission, to develop and enhance capabilities along the U.S.-Mexico border to detect, identify and report naturally occurring or intentionally inflicted bio-terrorist attack, perform epidemiological investigations of such outbreaks, electronically share clinical, laboratory and epidemiological information with public health officials in neighboring health jurisdictions, and train public health personnel in surveillance and epidemiology related activities.

EWIDS complies with Homeland Security Presidential Directive/HSPD-21, to establish a “National Strategy for Public Health and Medical Preparedness (Strategy), which builds upon principles set forth in Biodefense for the 21st Century (April 2004) and will transform our national approach to protecting the health of the American people against all disasters”.

Homeland Security Presidential Directive/HSPD-21 (PDF 72 KB)

U.S.-Mexico Border Health Commission - Early Warning Infectious Disease Surveillance Program Guidance Document (PDF 268 KB)

Background

On December 13, 2003, in Saltillo, Coahuila, Mexico former Secretary of the U.S. Department of Health and Human Services (HHS), Tommy Thompson, and former Mexican Secretary of Health, Dr. Julio Frenk-Mora, jointly announced the provision of funding for the Early Warning Infectious Disease Surveillance program.

The HHS Office of the Assistant Secretary for Preparedness and Response (ASPR) provide the U.S. Northern and Southern Border States federal funds to develop and enhance epidemiology, and laboratory & infectious disease surveillance capacity along the international borders. EWIDS funds are distributed through the Centers for Disease Control and Prevention (CDC) Public Health Emergency Preparedness Cooperative Agreement.
 

Arizona and Sonora Efforts

The Arizona Department of Health Services (ADHS) Office of Border Health (OBH) and the Secretaría de Servicios de Salud de Sonora (SSS) have an historical collaborative partnership working on binational public health issues along the Arizona-Sonora border through the Health Service Committee under the auspices of the Arizona-Mexico Commission (AMC), and it’s sister organization, la Comisión Sonora-Arizona (CSA).

Binational Collaboration

Utilizing the Arizona Mexico Commission - Comision Sonora Arizona - Health Services Committee, the Office of Border Health, and the Sonora Secretariat of Health have been, and are continually working collaborative projects to improve preparedness, readiness and response to binational public health threats and incidents.

In 2006, the AMC-CSA Health Services Committee formulated a Declaration of Cooperation, signed by the Governors Janet Napolitano and Ing. Eduardo Bours Castelo and Health Directors Susan Gerard and Dr. Raymundo López Vucovich. The Declaration of Cooperation states that the Arizona Department of Health Services and the Sonora Secretariat of Services of Health will:

• Develop protocols between the ADHS and SSS on how appropriate public health information will be shared between both states,
• Coordinate the exchange of public health information between Arizona and Sonora to better protect the communities in the border region, and
• Develop an Arizona-Sonora regional response plan to pandemic influenza (an All Hazards response plan).

Arizona- Sonora Declaration of Cooperation 2006 (PDF 329 KB)
 

Binational Epidemiologic Surveillance

Binational collaboration through established networks between the Office of Border Health  and the Sonora Secretariat of Health has successfully helped prevent wide spread instances of communicable diseases reported by local health departments and jurisdictions, such as hepatitis A, measles, and bacterial meningitis. The OBH and SSS utilize recognized World Health Organization (WHO) International Health Regulations (IHR) for collaboration on identified binational infectious disease cases.

Binational collaboration goes beyond infectious diseases. It is comprehensive of Tuberculosis, food borne illnesses, and Sexually Transmitted Infections, as well as environmental health issues such as lead toxicity in homeopathic remedies and candy, air quality, and potential chemical spills.

Public Health Information Exchange / Protocols

The OBH and ADHS Electronic Disease Surveillance Program (EDSP) are coordinating the development of binational, bilingual functionality for MEDSIS, the Arizona Electronic Disease Reporting System. This will allow Arizona and Sonora to share important public health information electronically, in real-time, for defined binational infectious disease cases.

Congruently with binational MEDSIS development, the ADHS and SSS are developing protocols for communications, sharing of public health information, and investigations of binational infectious disease cases.

Regional Pandemic Influenza Plan

A binational regional influenza pandemic response plan has been written, and will be included as a supplement in the Arizona Pandemic Influenza Plan and the Sonora Plan Estatal de Preparación y Respuesta ante una Pandemia de Influenza.

Professional Exchange / Laboratory Capacity

In 2007, the Office of Border Health and Arizona State Public Health Laboratory (ASL) provided sponsorship, utilizing EWIDS funds, for two Sonora State Public Health Laboratory personnel, to attend a three-day Biosecurity Level III (BSL3) laboratory training course in Scottsdale, AZ. The training focused on Design and Construction of BSL3 Facilities and Safe BSL3 Work Practices and Procedures.

The OBH encourages participation of Sonoran Health Officials in state and locally sponsored conferences, meetings, trainings and professional exchanges to improve collaboration and information sharing. Future public health professional exchanges are being planned for State and Local Epidemiologists.

Exercises

Since 2004, Arizona and Sonora have participated in numerous binational Tabletop and Functional exercises focusing on public health and hazardous material scenarios at the State and Local levels.

Binational Health Councils / Consejo Binacional de Salud (COBINAS)

At the local level, Arizona Border County Health Departments collaborate with the Sonoran Border Health Jurisdictions through established COBINAS.

COBINAS were established along the U.S.-Mexico border by the U.S.-Mexico Border Health Association as a means to encourage and facilitate cross-border communication and collaboration among border communities. COBINAS provide an opportunity for health and welfare professionals within bi-national urban or rural settings to collaborate in creating cohesive outreach, treatment, and management within the binational community in which they live and work.

Through the COBINAS, health professionals are able to share pertinent health information and needs, and initiate vital relationships with their cross-border counterparts. Subcommittees are established and focus on public health and welfare issues that directly affect the local binational border communities, and work on binational community-specific projects. Updates and results are presented to the COBINAS co-presidents and members at the regularly scheduled meetings.

The Epidemiology Subcommittee fosters an essential binational collaborative partnership among border jurisdiction health departments that supports cooperation in binational epidemiologic surveillance and communication. Binational projects focus on EWIDS related activities, as well as other infectious disease issues, such as West Nile Virus, food-borne related illnesses, HIV/AIDS and sexually transmitted infections, etc.

There are currently three active COBINAS established along the Arizona-Sonora border, and a fourth that is currently in development:

• Cochise County – Northeast Sonora / Agua Prieta
• Santa Cruz County – Nogales, AZ (Ambos Nogales)
• Yuma County – San Luis Rio Colorado
• Tohono O’Odham -South Central Pima County – North Central Sonora (in development)

Participation in the COBINAS and subcommittees are open to health professionals in the private, not-for profit, non-governmental, academic, and governmental sectors that reside or work in binational border communities.

For additional information about the previous mentioned agencies please visit our links page or contact us for additional information about our program.