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United States-México Border Health Commission

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The United States-México Border Health Commission (BHC or Commission) was created as a binational health commission in July 2000, with the signing of an agreement by the Secretary of Health and Human Services of the United States and the Secretary of Health of México. On December 21, 2004, the Commission was designated as a Public International Organization by Executive Order of the President.

The mission of the United States-México Border Health Commission is to provide international leadership to optimize health and quality of life along the U.S.-México border.

The Commission is comprised of the federal secretaries of health, the chief health officers of the ten border states, and prominent community health professionals from both nations. The BHC has the unique opportunity to bring together the two countries and its border states to solve border health problems. The Commission provides the necessary leadership to develop coordinated and binational actions that will improve the health and quality of life on the border.

The United States-México Border

The border between the United States and México in some places is marked by a river, in other areas it is merely a line in the sands of the desert. Throughout history the border has been remapped by wars, politics, and nature. It has gone from an isolated, nearly uninhabited environment, to a bustling region of commerce and activity with a total combined population of nearly 12 million.

On a normal day, millions of trade items cross the line north and south. More than 800,000 people crisscross legally everyday, not counting the thousands who find illegal ways to enter the United States. Those who do find their way may risk their lives to rattlesnakes, scorpions and blistering heat or extreme cold. The lure of the north has brought millions of residents from the interior of México and other Latin American countries, to swell the border region past its economic limits and resources. The economic burden on the two countries is staggering. Much of the border is poor and health resources are scarce.

This rapid population growth is putting further pressure on an already inadequate medical care infrastructure, which further decreases access to health care. The border is impoverished and has a double burden of disease to bear. Like many emerging nations, it struggles with serious chronic diseases such as respiratory and gastrointestinal ailments. The large and diverse migrant population increases the incidence of communicable diseases such as HIV/AIDS and tuberculosis, as well as chronic illnesses such as diabetes, certain cancers, and hypertension. In addition, the problems and concerns affecting the border region have broad repercussions for both nations. Travelers, migrants and immigrants, who are crossing the border every day, are taking their health problems with them to other parts of the United States and México.

Although both nations cooperate in specific health areas such as tuberculosis and immunizations, until now, the border region lacked a sustainable process for addressing and improving the health of its population. A high-level binational commission was needed to effectively address these issues.

The Establishment of the United States-México Border Health Commission

In recognition of the need for an international commission to address border health problems, the United States Congress passed Public Law 103-400 in October 1994. This law authorized the president of the United States to reach an agreement with México to establish a binational commission to address the unique and severe health problems of the border region. In 1997, Congress approved funding for a commission through the U.S. Department of Health and Human Services, Office of International and Refugee Health. In July 2000, the U.S.-México Border Health Commission was created by the signing of an agreement by the U.S. Secretary of Health and Human Services and the Secretary of Health of México.

The Binational Agreement

On July 14, 2000, United States Secretary of Health and Human Services Donna Shalala signed the agreement establishing the Commission in Washington, D.C. Secretary of Health of México, Lic. Jose Antonio González Fernández signed the agreement on July 24, 2000 in México City.

The agreement is in effect for five years and will be automatically extended for additional five-year periods unless either party gives notice of withdrawal.

The mission and character of the United States-México Border Health Commission is to provide international leadership to optimize health and quality of life along the U.S.-México border.

The BHC was created to serve all the people who reside within 100 kilometers, or 62 miles, on either side of this international boundary line. The border area is comprised of six Mexican states and four states in the United States. Due to its binational character, and the membership of the chief health officers and community health professionals from all ten of the border states, as well as from both federal governments, the Commission serves the unique role of providing the necessary leadership to coordinate actions that will improve the health and quality of life of border residents.



The Commission is comprised of twenty-six members who are deeply committed to border health improvement. Each section, one for the United States and one for México, has thirteen members. The Commissioner of each section is the Secretary of Health from that nation. Each Commissioner may designate a delegate. The chief state health officer of the ten border states is a statutory member of the Commission, and the other fourteen members are appointed by the government of each nation.

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