Along both sides of the U.S.-Mexican border, the sense of crisis is palpable.
The COVID-19 pandemic is hammering the entire necklace of cities and towns strung along the boundary—from Tijuana to Matamoros, San Diego to Brownsville, with El Paso and Ciudad Juarez in between.
On the Texas-Mexico border, COVID-19 cases are spiking from Brownsville to El Paso. And Arizona’s leading border cities have seen COVID-19 cases rocket nearly a thousand percent in June 2020.
Border cities are umbilically linked—cliché but true. Their lifeblood is cross-border industry, commerce where tens of thousands, of people from both sides cross legally every day.
Thousands of foreign-owned Mexican factories, or maquiladoras, spin out just-in-time products that fill department store shelves coast-to-coast. Trucks full of Mexican grown fruits and vegetables continue to cross into the U.S. to fill supermarkets.
Though a non-essential travel ban exists, one cannot turn off the stream of goods and commuters traversing border ports of entry.
The border divides and unites a region with major inequalities. The prevalence of poverty and close-knit communities adds to the area’s vulnerability.
In this environment, COVID-19 has amplified and magnified fractured health care systems on both sides of the border. Prior to COVID-19, border residents faced significant challenges connecting with health systems, medical care and social services.
These disparities are now in sharp relief as COVID-19 sweeps through border communities. In Mexico, maquiladora workers are dying in droves.
Trump’s Dismantling of the the U.S.-Mexico Border Health Commission
Considering the border region’s unique vulnerabilities and the need for close binational cooperation in meeting the border’s public health challenges, you’d think the U.S. government would support an agency it designed just for this purpose. But no. The Department of Health and Human Services dumped it in 2017.
U.S.-Mexico Border Health Commission (BHC)—vigorously backed by the American Medical Association and authorized by Congress in 1994—was established by treaty in 2000 “to provide international leadership to improve health and quality of life along the U.S.-México border.”
The current administration completely disabled the BHC in 2017, closing shop in El Paso and reeling its budget and title back to the Department of Health and Human Services’ Office of Global Affairs—where it lies zombied, alive in name only. BHC’s Mexican part continues—albeit short of funds and with little coordination with its absent neighbor.
The absurdity of this retreat from binational collaboration in border public health is now fully on screen. Gone is the one body with the capacity and mandate to communicate, collaborate and coordinate responses in the border area. There is now no one working with Mexico’s public health and human service professionals to protect citizens in both countries, nor building goodwill in the process.
The “Makeshift” Response to COVID-19
The U.S. COVID-19 pandemic response is exhibit A. Overall, it has been handled in a makeshift manner, especially so on our southern border.
Before being dismantled, the BHC would have had the unique capability to mobilize the two countries and their border states to confront infectious diseases and address the spectrum of border health challenges in a manner that betters the health and quality of life of all border residents.
The BHC’s revival is urgently needed to coordinate binational responses to infectious diseases and outbreaks like the COVID-19 crisis; to share data across the border; mobilizing doctors, nurses, health care workers and clinics as well as hospitals to confront the common threat; to engage in epidemiological surveillance; and to launch a bilingual outreach initiative to educate families on physical distancing, sanitation, health resources and means of coping with quarantine conditions.
Yet the Trump administration is now headed in the opposite direction. It’s 2021 budget proposal not only fails to support the BHC—it zeroes out the U.S.-Mexico border environmental program that supports environmental health along the boundary.
For Trump, it seems, the border is a swamp not worth draining, best ignored altogether.
Sadly, there was once a thriving Border Health Commission. But please don’t tell beleaguered health professionals up and down the border that the very organization that they need right now was once but is no more. At this particular moment it’s the last depressing thing they need to know.