December 12, 2000

For decades, numerous studies on border health issues have been the subject of much ado and binational conversations, forums, conferences, seminars at public and private sector levels. The common ground has been the understanding that diseases have no borders.

Grassroots efforts since the early 1980's by State and local U.S.-Mexico border governmental and non-governmental organizations working together to foster support for a border health commission finally led to agreement. The Governors of the Sates of California, Texas, New Mexico, and Arizona formally endorsed the concept of establishing a United States-Mexico Border Commission in 1994.

The endorsement led to the introduction of legislation in the U.S. Congress as Public Law 103-400, approved on October 22, 1994. The Act authorized the President to conclude an agreement with Mexico to establish a binational commission to be known as the United States-Mexico Border Health Commission.

The Commission's duties were identified as:

1.      to conduct a comprehensive needs assessment in the US-Mexico Border Area for the purpose of identifying, evaluating, preventing, and resolving health problems and potential health problems that affect the general population of the area;

2.      To implement the actions recommended by the needs assessments through:

A.     assisting in the coordination and implementation of the efforts of public and private entities to prevent and resolve such health problems, and

B.     assisting in the coordination and implementation of efforts of public and private entities to educate such population in a culturally competent manner, concerning such health problems.

The Act also authorizes the Commission to perform functions as it determines to be appropriate:

1.      to conduct or support investigations, research, or studies designed to identify, study, and monitor, on an on-going basis, health problems that affect the general population in the US-Mexico Border Area;

2.      to conduct or support a binational, public-private effort to establish a comprehensive and coordinated system, which uses advanced technologies to the maximum extent possible, for gathering health-related data and monitoring health problems in the United States-Mexico Border Area; and

3.      to provide financial, technical, or administrative assistance to public or private nonprofit entities who act to preserve or resolve such problems or who educate the population concerning such health problems.

The US side of the BHC will work as part of the Department of Health and Human Services under the leadership of the Secretary of Health and Human Services. The Secretary worked with the appropriate Mexican federal officials for the binational participation in the BHC. Mexico has also adapted the necessary legislation and procedures for working with the BHC.

The BHC was not formed as a replacement for other activities now carried out by public and private sector organizations, to the contrary, it is mandated to pull together and support those efforts. It can become a forum for tackling critical issues, and developing the necessary resources such as - political will, community commitment, technical expertise, and financial resources to address needs along the entire 2000-mile border area. It will prioritize issues and strive to avoid duplicating other ongoing efforts, or ensuring that new ones are value added.

To get a sense of the enormity of the BHC's mandate, the Border Area as is legally defined under the La Paz Agreement (1983) as the region within 62 miles (100KM) of the border. Thus the border region is approximately 250,000 square miles with a current border population exceeds 11 million, and expected to double on the Mexican side by 2006 and the US side by 2020.

The implications for the San Diego-Tijuana border region are immense. The US Consulate in Tijuana reports that 177,000 American expatriates live in the Baja California Peninsula; Tijuana, home to the largest contingency of maquiladoras in Mexico, has American management living in San Diego and working in Tijuana; thousands of American manufacturing representatives, consultants and technical personnel cross back and forth daily; there are over 70 million annual (legal) border crossings; trade in goods and services top $9 billion a year. The massive movement of people back and forth across the border makes border health issues a top concern and priority.