One of the first negative impacts of the COVID-19 pandemic and the subsequent public health and social measures introduced by health authorities quickly became visible, particularly at borders. The pandemic resulted in border closures and controls, disrupting the cross-border movements of health care, medical and pharmaceutical goods, as well as food and basic supplies. It also sowed confusion and distrust.
Following the outbreak, it became evident that the role of point of entry (PoE) authorities was poorly defined with regards to coordinating the response to COVID-19. This was problematic for the clearance of essential goods used for fighting the disease, including medical devices and personal protective equipment, recalls Dr Evangelos Karagiannis, Public Health Doctor, Port Health Authority of Thessaloniki, Greece.
PoEs are at the frontline of prevention, detection and response to public health events that may arise via international travel and transport. PoEs include ports, ground crossings and airports. As stipulated in the International Health Regulations (IHR) (2005), PoEs must be equipped with routine core-capacity requirements, as well as requirements for responding to a public health emergency of international concern, including a public health emergency contingency plan.
The challenges related to COVID-19 have underscored the important role that PoEs play in maintaining trade connectivity and ensuring the cross-border movement of goods, Dr Karagiannis says. He stressed that this is not just for the immediate pandemic response, but also for the subsequent recovery efforts to build resilience to future disruptions and ensure the ability to respond to health threats. “It is important to establish good collaboration between all institutions with a stake in protecting public health before and after a crisis hits. In this way, we are able to keep working together after a crisis and take advantage of the lessons learned from it,” Dr Karagiannis adds.
To further improve health system strengthening and PoE capacities, on 21–23 November 2023 WHO/Europe, in partnership with the WHO Collaborating Centre for the International Health Regulations: Points of Entry (University of Thessaly, Greece), organized a subregional workshop on border health in Thessaloniki, aiming at collectively strengthening capacities to detect and contain public health threats at PoE, with a focus on ports and ground crossings. The workshop brought together 39 public health officials, IHR national focal points and experts from the western Balkans and surrounding countries, including representatives of strategic partners, to discuss and exchange experience on the implementation of the IHR (2005) core capacities for border health and identify gaps and priority actions to strengthen cross-border collaboration.
“Exercises like this workshop help us share experiences, and exchange ideas and insights with our counterparts, and consequently, help all our institutions perform their duties better,” says Dorothea Panagiotou, Public Health Inspector, Port Health Authority of Thessaloniki. “Before COVID-19, we were aware of the other PoEs only on paper, and as a matter of fact, COVID-19 was a real-life example that brought us in touch with other counterparts, and we should continue this cooperation in the future,” she added.
According to Professor Christos Hadjichristodoulou, President of the Greek National Public Health Organization, and EU Healthy Gateways Joint Action Coordinator, “This is a unique opportunity to build and maintain a network of PoE experts at a regional level, which is also going to help foster future cooperation, exchange of knowledge, information and best practices to improve border health collaboration, and make this network sustainable”.
“We at WHO deliver a series of capacity-building activities at points of entry to foster cross-border collaboration between Member States,” says Tanja Schmidt, Team Lead, Preparedness, Readiness and Capacity Building, Health Emergencies Programme, WHO/Europe. “As we have experienced in recent health emergencies, points of entry are really at the frontline of prevention, detection and response to public health risks, and that is why we are here: to support the health staff and health systems at points of entry,” Ms Schmidt adds.
“We want to ensure that countries are capable of responding to health threats at points of entry at all times and during emergencies,” stresses Dr Abebayehu Assefa Mengistu, Coordinator of the WHO Health Emergencies Balkan Hub. “Those core capacities are required for timely detection and effective response to any potential hazard that may occur at point of entry,” he says.
Background to the workshop
This workshop for the western Balkans and surrounding countries focused on collectively strengthening capacities to detect and contain public health threats at PoE, with a focus on ports and ground crossings.
In September 2018 the WHO Regional Committee for Europe highlighted PoE as one of the critical areas of its first strategic pillar. It called on all Member States to “develop and maintain routine and emergency capacities at designated points of entry and ensure regular evaluation” to help strengthen preparedness and management of cross-border health threats.
Despite these provisions, countries have faced challenges in developing the capacities outlined in the IHR (2005). The subregional workshop aimed to address this by offering guidance on enhancing cross-border collaboration among neighbouring countries to harmonize resources, strengthen coordination and communication, and enable joint operations or efforts, particularly regarding public health threats of mutual concern.
The workshop was coordinated by WHO/Europe with financial support from the European Union.