Though your attention is largely focused on addressing the short term challenges posed by the corona virus pandemic, as is ours, it is also important to keep in mind longer-term objectives and opportunities for when the crisis ends. In that spirit, Monarch Global Strategies is pleased to share Pandemics and Beyond: The Potential for U.S.-Mexico Cooperation in Public Health.

The paper reviews past bilateral collaboration on epidemics, identifies a number of specific areas for additional public-private and private-private collaboration, and provides specific recommendations for policy actions to be taken once the crisis abates.

Bilateral collaboration to address prior health crises extends back at least as far as the 2002-2004 SARS and 2009 H1N1 pandemics. The paper traces the 2007 creation of the North American Plan for Avian and Pandemic Influenza (NAPAPI) which was updated in 2012 following the H1N1 pandemic. NAPAPI provides a policy framework to enhance trilateral collaboration in the event of an outbreak and called for preventing the spread of viral outbreaks from outside the region as well as halting and slowing pandemics within North America.

The traits that bind Mexico and the United States through trade and economics can also form the basis for collaboration and cooperation in health policy and healthcare delivery in both the public and private sectors.

A critical element of the NAPAPI was to identify the relevant ministries and agencies in all three countries, as well as the existing national emergency plans. NAPAPI also committed the signatories to take a series of actions intended to enhance communication and coordination regarding response strategies and the sharing of best practices and lessons learned.

The United States and Mexico reaffirmed the importance of NAPAPI in January 2019 and it is being employed by health and foreign ministries in the United States and Mexico as a channel of communication, more than technical or material assistance, as each government struggles with the national response (as might be expected in this phase of the crisis). 

The traits that bind Mexico and the United States through trade and economics can also form the basis for collaboration and cooperation in health policy and healthcare delivery in both the public and private sectors. Cross-border collaboration could enhance access to medicines, devices, and diagnostics, improve efficiency of healthcare delivery, and create jobs in both countries. We identify several specific areas for enhanced collaboration including:

• Regulatory Cooperation (for regulatory approvals and sharing responsibility for inspections to verify compliance)
• Clinical Trials (multi-center trials and collaboration on policy issues such as informed consent and protection of patient data)
• Medical Tourism (individual and corporate-sponsored comprehensive programs)
• Health Systems (including Value Based Health Care pilot projects and telemedicine)
• Manufacturing (taking further advantage of the comparative advantages of North America to produce pharmaceuticals, diagnostics, and devices)
• Training and Academic Exchanges (which could address nursing shortages in both countries and reduce costs)

Finally, the paper identifies several areas for present and future cooperation including:

• Once the crisis has passed, updating NAPAPI to reflect lessons learned from COVID-19
• Greater coordination of regulation of pharmaceuticals, diagnostics, and devices to eliminate duplication and red-tape
• Collaboration to bring Value Based Health Care programs to populations in both countries
• Enhanced integration of manufacturing of healthcare products
• Cross-border multi-stakeholder collaboration to address human capital needs in public health

Download the full report here.

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Andrew Rudman is the managing director of Monarch Global Strategies LLC.

Duncan Wood is the director of the Mexico Institute at the Woodrow Wilson Center.

The views and opinions expressed here are those of the authors and do not necessarily reflect the official policy or position of the Pacific Council.