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. 2021 Jun 21;17(1):62.
doi: 10.1186/s12992-021-00709-0.

Managing borders during public health emergencies of international concern: a proposed typology of cross-border health measures

Kelley Lee  1 , Karen A Grépin  2 , Catherine Worsnop  3 , Summer Marion  3   4 , Julianne Piper  5 , Mingqi Song  2
Affiliations

Managing borders during public health emergencies of international concern: a proposed typology of cross-border health measures

Kelley Lee et al. Global Health. .

Abstract

Background: The 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.

Results: Based 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 - policy goal, type of movement (travel and trade), adopted by public or private sector, level of jurisdiction applied, stage of journey, and degree of restrictiveness. These categories are then brought together into a proposed typology that can support research with generalizable findings and comparative analyses across jurisdictions. Addressing the current gaps in evidence about travel measures, including how different jurisdictions apply such measures with varying effects, in turn, enhances the potential for evidence-informed decision-making based on fuller understanding of policy trade-offs and externalities. Finally, through the adoption of standardized terminology and creation of an agreed evidentiary base recognized across jurisdictions, the typology can support efforts to strengthen coordinated global responses to outbreaks and inform future efforts to revise the WHO International Health Regulations (2005).

Conclusions: The 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.

Keywords: Border management; COVID-19; Cross-border health measures; International Health Regulations; Trade measures; Travel measures; Typology.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
International travel controls during the COVID-19 pandemic, Dec 10, 2020. Source: https://ourworldindata.org/policy-responses-covid
Fig. 2
Fig. 2
Restrictions on internal movement during the COVID-19 pandemic, Dec 10, 2020. Source: https://ourworldindata.org/policy-responses-covid
Fig. 3
Fig. 3
Proposed typology of cross-border health measures
See this image and copyright information in PMC

References

    1. Lee K, Worsnop K, Grepin K, Kamradt-Scott A. Comment: global coordination on cross-border travel and trade measures crucial to COVID-19 response. Lancet. 2020;395(10237):1593–1595. doi: 10.1016/S0140-6736(20)31032-1. - DOI - PMC - PubMed
    1. Habibi R, Burci GL, de Campos T, et al. Comment: do not violate the international Health regulations during the COVID-19 outbreak. Lancet. 2020;395(10225):664–666. doi: 10.1016/S0140-6736(20)30373-1. - DOI - PMC - PubMed
    1. Haseltine W. Travel Bans Won’t Stop The Spread of New Variants – Travel Restrictions Might. Forbes. 2021.
    1. Saunders D. Why Travel Bans Fail to Stop Pandemics. Foreign Affairs. 2020.
    1. WHO . International Health Regulations. 2005.

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