Virtual meeting on cross-border collaboration for elimination of kala-azar and malaria along the India international border with Bangladesh, Bhutan and Nepal

1. To review current situation and progress in kala-azar and malaria elimination in bordering districts along the international border
2. To review the current cross-border collaboration efforts and discuss issues hindering progress
3. To plan the way forward for cross-border collaboration for accelerating kala-azar and malaria elimination along the international borders in respective countries

• The persistence of malaria in border areas remains critical concern and a frequently cited challenge to achieve and sustain disease elimination. Generally, border areas are remote and difficult to reach areas with special population including ethnic groups, indigenous population, migrants without proper documentation, many of those facing socio-economic hardships. There is high receptivity with favorable ecological conditions for transmission and risk of importation due to population movement. In addition Weak health systems pose a challenge.
• For more than two decades, efforts have been made in the SEA Region to tackle malaria along international borders and through cross-border collaboration. Cross-border collaboration has been emphasized for kala-azar control and elimination as well.  
• Member countries have committed to address malaria along international border by signing/endorsing ministerial declarations as well as others. Several bilateral and international meetings have been conducted but only few examples of success are available
• Challenges include lack of priority towards commitments for cross-border collaboration and sufficient and sustained resources for cross-border component (domestic/external).
• In addition, operational challenges are inadequate situation analysis to inform comprehensive planning and action as well as irregular follow-up and coordination support and absence of new and/or minimal use of existing platforms (web-based/electronic) for information sharing and harmonization of efforts,  

1. For countries (immediate)

• The first priority should be given to improve access to health care and to strengthen surveillance in border districts within national boundaries. 
• Carry out situation analysis and epidemiological assessment of each border district within national boundaries and update periodically
• Update country NSPs to strengthen prevention, control and surveillance and M&E activities in border districts, as needed.
• Multisectoral coordination: Strengthen collaboration and coordination with other sectors such as finance, education, immigration, security, tourism, labor, private sectors and others in border districts within your boundary, to resolve the bottlenecks in improving access to health care in border districts and to improve the efficiency and impact of interventions to target population
• Cross border collaboration
  • Update /develop list of focal/nodal points and a local committee
  • Remove the barriers and reduce the administrative procedures to support cross border collaboration at local level
  • Empower local officials for decision-making and data/information sharing

2. For countries (short to medium term) 

• Develop SOP for cross-border surveillance and M&E: 
  
• Empower local officials for decision-making and data/information sharing. 
• Conduct district-to-district coordination meetings (quarterly) for joint review, planning and action.
• Constitute task force/include cross border coordination in existing task force.
• Conduct implementation research, as needed.
• Ensure cross-learning from other disease control/elimination programmes.
• Pursue advocacy at high levels and with donors with special emphasis on  of sufficient and sustained resources.

• Strengthen capacities at state, district and sub-district levels with special emphasis on epidemiological analysis, surveillance and M&E.
• Provide technical assistance for:
  • assessments/analyses
  • strengthening/updating NSPs, guidelines, SoPs
  • implementation research
  • acceleration of control/elimination programmes
  • monitoring progress.
  • Conduct partner landscape analysis
• Coordinate collaboration with various partners and stakeholders.
• Facilitate and support organization of meetings at national/state/district levels.
• Support coordination with countries for establishing regional data/information sharing platform 
• Organize sensitization of programme managers/implementing entities especially from local levels, and partners.