The San Diego-Baja California region faces some significant cross-border health care challenges in the coming years which ,if left un-addressed, could have irreparable consequences on the regional economy on both sides of the international border.     Clearly, more can and should be done by governments to better coordinate initiatives at the local, regional, state and federal levels.  Governments, however, are not in a position to address the growing trans-boundary health care challenges alone. 

Recognizing the critical importance of the region’s binational health issues and the existing institutional impediments to effective programs, ICF is calling on the area’s leaders to take urgent action.  If our binational region is to effectively address our future health care challenges, greater cooperation will be needed by the private sector, government, academia, the nonprofit sector as well as funders (individual and foundations) committed to making a difference.   The most knowledgeable border experts know unequivocally that leadership in border health must be situated at the border for the well being of not just those living at the border but the citizens of both the United States and Mexico.   Unfortunately, exchange of critical health problems can seriously undermine any success in economic and other societal problems. 

Where policy reforms are needed, there is a pressing need for stakeholders in our border region to work more closely together in the area of public advocacy to press for critically needed changes to improve the quality of care and reduce the public health risk of our residents.  Where potential policy solutions exist, there is critical role for philanthropy to play from both sides of the border in funding research that can provide the needed data to validate critical needs and substantiate proposed policy reforms.

 A concerted effort must be made to identify the business benefits for more pro-active private sector involvement in responding to critical cross-border health needs particularly in the area of leveraging technology (e.g. telemedicine) or financial solutions to improve binational access to care.   Finally, given the scarcity of resources currently supporting border health initiatives, there is a critical need for greater communication and collaboration across the sector.   

The San Diego-Baja California border region faces a number of critical cross-border health challenges which could be effectively addressed through changes in public policy or administrative actions at the federal levels of government in both the United States and Mexico.  Yet, to shape change it is critical that border area health practitioners  get more engaged in public advocacy helping elected officials and other key decision makers make the  changes in policy that can reduce health risks along the border. 

While San Diego-Baja California’s healthcare needs are well documented and several near term actions have been identified as priorities in this report, there is a pressing need for key decision-makers to come together to formulate strategies for expanded cooperation and engagement.  Here, ICF recommends the key public, private and nonprofit decision-makers come together soon at a cross-border health summit to examine critical issues and develop an actionable plan aimed at dramatically increasing the level of attention and commitment to action on cross-border health issues in the region.   

As one of the few local public charities in the border region with a cross-border philanthropic mission, ICF is committed to playing a pro-active leadership role to elevate border health issues as a priority to key decision makers in the region.  Leaders from all sectors must see first-hand the cross-border health risks, priority needs, and efforts that can make a difference.  All too frequently, the region’s leaders have little direct experience with communities on the border.  Towards this end, ICF is committed to organizing a series of leadership tours to highlight border area health needs and opportunities on both sides of the border.

Much work remains to be done but working together with key stakeholders from the public, private and nonprofit sector as well as funders and readers like you, systemic changes are possible that will ,over time, improve the quality of health among all residents of our border region irrespective of socio-economic class, nationality or immigration status.  

ICF invites you to join in these efforts -- border health issues really do matter.  The status quo is simply not acceptable.  Waiting for further deterioration in public health or for a flu pandemic to prompt action is betting with the future of the region and the lives and well-being of rich and poor alike.   Whether one lives in a gated community or in informal housing with limited basic infrastructure and no running water , the residents of the San Diego-Baja California region share the same air, shopping malls, public and recreation spaces, public transportation systems, workplaces, and even the same restaurants.  The state of our region’s border health is only as sound as its weakest link.  Even today, the economic consequences of rising health costs and reduced productivity, combined with potential border closures from quarantines, are simply far too great to ignore.

Regardless of what side of the border we occupy, when it comes to public health issues we share the same destiny.  We should do all we can to ensure that our destiny is one of our choosing and good for one and all.

Children at Hospital General de Tijuana. Photo Credit: Amy Carstensen, ICF.