Managing Borders During Public Health Emergencies of International Concern: A Proposed Typology of Cross-border Health Measures

Abstract

BackgroundThe near universal adoption of cross-border health measures during the COVID-19 pandemic worldwide has prompted significant debate about their effectiveness and compliance with international law. The number of measures used, and the range of measures applied, have far exceeded previous public health emergencies of international concern. However, efforts to advance research, policy and practice to support their effective use has been hindered by a lack of clear and consistent definition. ResultsBased on a review of existing datasets for cross-border health measures, such as the Oxford Coronavirus Government Response Tracker and World Health Organization Public Health and Social Measures, along with analysis of secondary and grey literature, we propose six categories to define measures more clearly and consistently – type of movement (travel and trade), policy goal, level of jurisdiction, use by public versus private sector, stage of journey, and degree of restrictiveness. These categories are then be brought together into a proposed typology that can support research with generalizable findings and comparative analyses across jurisdictions. The typology facilitates evidence-informed decision-making which takes account of policy complexity including trade-offs and externalities. Finally, the typology can support efforts to strengthen coordinated global responses to outbreaks and inform future efforts to revise the WHO International Health Regulations (2005). ConclusionsThe widespread use of cross-border health measures during the COVID-19 pandemic has prompted significant reflection on available evidence, previous practice and existing legal frameworks. The typology put forth in this paper aims to provide a starting point for strengthening research, policy and practice.

How to organise travel restrictions in the new future: lessons from the COVID-19 response in Hong Kong and Singapore

“…In some extreme scenarios (eg, when facing novel variants that may break the established immunity), governments may temporarily shut down the borders (ie, implement travel bans) to prevent their health systems from becoming overwhelmed, with specific exemptions to protect necessary import and export travel. These precautionary actions, however, may lead to enormous economic and humanitarian hardship 24. Alternatively, governments can relax regulations for travellers from regions with a low local incidence rate or a high vaccination rate.…”

“…Governments generally implement travel restrictions with multiple health and non-health policy goals. According to Lee et al ,24 these goals are often competing, with corresponding trade-offs. This can be contextualised as the stringency-flexibility trade-off of travel restrictions: on one hand, stringent travel restrictions certainly mitigate the importation and transmission risk of COVID-19 but also bring a myriad of adverse outcomes in society and the economy; on the other hand, relaxed travel restrictions may revitalise international travel while leaving the local population at risk.…”

Implementation of Transboundary Policy in the Republic of Indonesia-Papua New Guinea Border Area in Keerom Regency

“…Efforts to determine borders with neighboring countries can be carried out by means of border diplomacy (Lee et al, 2021). The existence of a complete and clear determination of regional boundaries can reduce the possibility and intensity of border conflicts.…”