N - Global Health Institute - University of Arizona

6
The Establishment of the United States-México Border Health Commission
In recognition of the need for an international commission to address border health problems, the United States
Congress passed Public Law 103-400 in October 1994. This law authorized the president of the United States
to reach an agreement with México to establish a bi-national commission to address the unique and severe
health problems of the border region. In 1997, Congress approved funding for a commission through the U.S.
Department of Health and Human Services, Office of International and Refugee Health. In July 2000, the U.S.-
México Border Health Commission was created by the signing of an agreement by the U.S. Secretary of Health
and Human Services and the Secretary of Health of México.
The mission of the United States-México Border Health Commission (BHC) is to provide international leadership
to optimize health and quality of life along the U.S.-México border. The Commission is comprised of twenty-six
members who are deeply committed to border health improvement and include the federal secretaries of health,
the chief health officers of the ten border states, and prominent community health professionals from both
nations. Each section, one for the United States and one for México, has thirteen members. The Commissioner
of each section is the Secretary of Health from that nation. Each Commissioner may designate a delegate. The
chief state health officer of the ten border states is a statutory member of the Commission, and the other fourteen
members are appointed by the government of each nation. BHC has the unique opportunity to bring together the
two countries and its border states to solve border health problems. The Commission provides the necessary
leadership to develop coordinated and bi-national actions that will improve the health and quality of life on the
border.
The United States-México Border
The BHC was created to serve all the people who reside within 100 kilometers, or 62 miles, on either side of this
international boundary line. The border area is comprised of six Mexican states and four states in the United
States. The border between the United States and México in some places is marked by a river, in other areas it is
merely a line in the sands of the desert. Throughout history the border has been remapped by wars, politics, and
nature. It has gone from an isolated, nearly uninhabited environment, to a bustling region of commerce and activity
with a total combined population of nearly 12 million.
On a normal day, millions of trade items cross the line north and south. More than 800,000 people crisscross
legally every day, not counting the thousands who find illegal ways to enter the United States. Those who do find
their way may risk their lives to rattlesnakes, scorpions and blistering heat or extreme cold. The lure of the north
has brought millions of residents from the interior of México and other Latin American countries, to swell the
border region past its economic limits and resources. The economic burden on the two countries is staggering.
Much of the border is poor and health resources are scarce.
This rapid population growth is putting further pressure on an already inadequate medical care infrastructure,
which further decreases access to health care. The border is impoverished and has a double burden of disease
to bear. Like many emerging nations, it struggles with serious chronic diseases such as respiratory and
gastrointestinal ailments. The large and diverse migrant population increases the incidence of communicable
diseases such as HIV/AIDS and tuberculosis, as well as chronic illnesses such as diabetes, certain cancers, and
hypertension. In addition, the problems and concerns affecting the border region have broad repercussions for
both nations. Travelers, migrants and immigrants, who are crossing the border every day, are taking their health
problems with them to other parts of the United States and México. Although both nations cooperate in specific
health areas such as tuberculosis and immunizations, until now, the border region lacked a sustainable process
for addressing and improving the health of its population. A high-level bi-national commission was needed to
effectively address these issues.