EWIDS Background and Context:

Terrorism is an ever-present threat in our times.  Bioterrorism is of special concern because its human consequences can be so devastating, its weapons relatively easy to obtain and disseminate, and its effects often not detectable for days or even weeks.  The ability of a bioterrorist attack to create massive numbers of casualties (on a scale that overshadows other forms of terrorism) makes bioterrorism today’s most dangerous threat.  For this reason, the U.S. Government has assigned the highest priority to developing nation-wide domestic capabilities to prepare for and respond to bioterrorism and other outbreaks of infectious diseases.  A terrorist-triggered outbreak of a dangerous and highly communicable disease such as smallpox would require a concerted response by the public health emergency response system to prevent catastrophic mortality and morbidity.  Because pathogens do not recognize or respect geopolitical boundaries and travelers who cross the border into Mexico from the United States (and vice versa) can spread a contagious disease rapidly, early warning surveillance and prompt sharing of findings of concern among the six Mexican and four U.S. states along the U.S.-Mexico border and beyond is a public health and national security imperative.

The Early Warning Infectious Disease Surveillance (EWIDS) program consists of two companion but separate initiatives, the first of which involves the U.S. Mexico Border Health Commission (BHC) and the second of which focuses on the enhancement of cross-border surveillance and epidemiological capacities within the 20 U.S. states sharing borders with Mexico and Canada.

Along the southern border, EWIDS funds have also been separately awarded to Texas, New Mexico, Arizona and California to improve and strengthen capabilities that will complement those being developed by their Mexican counterparts so that the systems on both sides of the border will be coordinated and interoperable (in this context, the ability of different types of computers, networks, operating systems, and applications to work together effectively).  EWIDS related activities undertaken by the four U.S. border states are intended to be an intrinsic element of the overall public health emergency preparedness efforts supported by the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services.  In a similar vein, BHC EWIDS activities to be carried out by the six Mexican border states and the Secretariat of Health (SOH) of Mexico should reflect relevant priorities on prevention and health promotion as stated in Mexico’s National Health Act through the policies established by the National Council for Health Security, and in accordance with the lines of action established in the Mexican National and State Bioterrorism Health Protection Plans as well as in the National Guidelines for Health Security.

Both sets of EWIDS activities (in the United States and in Mexico) are intended to strengthen critical capacities in surveillance and epidemiology, laboratory capacity for biological agents, surveillance related communication and information technology, and surveillance/epidemiology related education and training.  The common feature to both of these initiatives is (1) the emphasis on cross-border infectious disease surveillance and epidemiology and (2) the involvement of all ten state health officers and bioterrorism coordinators (or their designated representatives) of the U.S. and Mexico border states in any planned activities.  This is to ensure that planning and implementation efforts by the four U.S. southern border states for the EWIDS project are harmonized with comparable efforts by neighboring jurisdictions in Mexico’s six northern border states.  Thus, the overall goals of both EWIDS projects is to enhance coordination among neighboring states in the U.S. and Mexico; to improve surveillance capabilities at the state, local and tribal level; to launching an epidemiological investigation promptly; to share surveillance (including laboratory) data; and to provide for appropriately trained public health personnel for these activities.