Kagera, a critical border region in Tanzania, serves as a gateway connecting multiple countries, including Uganda, Burundi, and Rwanda. Its strategic position makes it highly vulnerable to emerging and re-emerging infectious diseases. With the Marburg Virus Disease (MVD) in Tanzania and concurrent outbreaks such as Ebola in Uganda, Mpox in the DRC and Burundi, cross-border public health collaboration has never been more urgent.
This urgency prompted the Tanzania Ministry of Health, with support from the East, Central, and Southern Africa Health Community (ECSA-HC), WHO, and technical support from Africa CDC, the International Organization for Migration, and other partners, to convene a cross-border meeting between Tanzania and Burundi. Held from February 10-12, the meeting focused on revitalizing Public Health Emergency Contingency Plans (PHECPs), enhancing disease surveillance, and strengthening joint preparedness and response efforts among border health authorities.
“This region faces a high risk of disease outbreaks due to dynamic cross-border movement,” said Josephine Vito Kaing, Environmental Health Officer and Epidemiologist, Ministry of Health, Tanzania. “People travel daily for trade, work, education, religious activities, and even traditional healing, making coordinated preparedness and response essential.”
The Joint Cross-Border Committee, in line with the WHO International Health Regulations (IHR 2005), plays a pivotal role in coordinating health security efforts between Tanzania and Burundi. The committee consists of surveillance teams, border management authorities, and health officials from both nations, ensuring a harmonized approach to outbreak preparedness and response.
Diseases do not recognize borders, and a public health threat in one country can quickly escalate into a regional or even global crisis. “A problem in Tanzania is a problem in Burundi and beyond. This is why cross-border committees must be formalized and fully operational to ensure coordinated prevention and response measures,”said Dr. Remedius Kakulu, Public Health Specialist and IHR Focal Point for Tanzania.
While some countries have strong Public Health Emergency Contingency Plans (PHECPs), disparities in preparedness, resources, and response capacity create challenges for coordination, he explained. To bridge these gaps, the cross-border committee plays a critical role in synchronizing disease surveillance efforts, improving information-sharing mechanisms, and harmonizing response measures to ensure a unified approach across borders.
The Cross-Border Committee, which includes national and regional health authorities, border management teams, and key stakeholders, is instrumental in aligning public health actions.
Dr. Mushi Benedict, Senior Knowledge Management and Public Health Specialist at ECSA-HC, highlighted a key challenge in implementing cross-border health security—unsynchronized funding. While some border areas receive financial support for vaccination campaigns and emergency preparedness, others lack the necessary resources, leading to inconsistencies in intervention efforts. He explained that although countries are willing to collaborate, the absence of harmonized funding mechanisms hampers long-term sustainability. Additionally, porous borders remain a major concern, as many travellers use unofficial routes, making disease detection and containment efforts even more difficult.
Dr. Nyandwi Stanislas, Technical Director of Preparedness, Response, and Resilience of Health Emergencies from Burundi, echoed similar concerns. “While cross-border committees are in place, countries often struggle with inadequate human resources, both in terms of numbers and technical expertise,” he said. Border health officers lack proper training and equipment, making it difficult to implement effective surveillance and containment measures.
Despite efforts to establish structured border health interventions, limited financial resources prevent countries from scaling up their preparedness strategies. He called for greater investment in joint outbreak response planning and harmonized disease surveillance measures across the region.
The meeting resulted in several key agreements, including updating Public Health Emergency Contingency Plans, conducting tabletop simulations—discussion-based exercises where key personnel gather to evaluate their emergency response strategies—and enhancing joint disease surveillance through improved coordination.
Participants emphasized the need to integrate community-based surveillance mechanisms by engaging local leaders, traditional healers, and religious figures in health communication efforts. Training on the use of RING (Recognize, Isolate, Notify, Give) support cards for early identification of ill travelers was also highlighted as a critical area of focus.
Africa CDC, a key technical partner in the meeting, reaffirmed its commitment to supporting cross-border public health initiatives. Neema Kamara, Africa CDC’s Field Coordinator for the MVD response in Kagera, emphasized that preparedness must be prioritized alongside response efforts.
“At Africa CDC, we recognize that responding to outbreaks is not enough—we must also invest in preparedness. Strengthening border public health information-sharing, synchronizing surveillance systems, and empowering local staff are key steps to ensuring we prevent future crises rather than just reacting to them,” she said.
The meeting concluded with a strong call to action directed at international partners, regional entities, and governments. Stakeholders urged the formalization and sustainable funding of cross-border health committees to ensure long-term coordination beyond donor-funded projects.
Key recommendations included integrating harmonized standard operating procedures across all border posts, expanding risk communication strategies in multiple languages, and prioritizing joint outbreak preparedness programs.
The outcomes of this meeting underscored a critical message—borders should not be barriers to health security. Countries must work together to strengthen regional health systems, synchronize disease response efforts, and ensure that no community is left vulnerable to the threat of emerging infectious diseases.
“When we collaborate, we learn from each other’s successes and challenges. This is the only way we can build a stronger, more resilient health security framework for the region,” said Dr. Stanislas from Burundi.
With emerging health threats continuing to evolve, the need for sustained investment in cross-border public health security has never been greater. Africa must take bold steps to prioritize preparedness, harmonize surveillance strategies, and build resilient health systems—because no country is truly safe until its neighbors are safe as well.
