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Border health experts say the U.S.-Mexico Border Health Commission plays a fundamental role in encouraging coordination and collaboration between the U.S. and Mexico federal governments on public health. But the commission’s work fell by the wayside during the Trump administration, leaving it poorly positioned to exercise leadership during the COVID-19 pandemic.
The Biden administration is working to strengthen the commission again, says Maria Julia Marinissen, who was named acting director of the U.S. side of the commission in fall 2021. The binational institution founded in 2000 is tasked with improving health in the Borderland.
Marinissen also serves as the health attaché for the U.S. embassy in Mexico. She was previously U.S. liaison to the Global Health Security Initiative and the founder and chair of the former North American Health Security Working Group. She spoke to the El Paso Times by video call from Mexico City about the future of the U.S.-Mexico Border Health Commission.
What was the state of the U.S. section of the commission when you took the helm?
Our collaboration with Mexico has been very, very close. We have a permanent attaché in Mexico City, one of six in the world. So clearly, the collaboration with Mexico is a priority, especially on health matters.
I think that the reason I was appointed to be the the director, at least for the time being is because that relationship is so important that we want to ensure that the border actions were really aligned with the federal policies, and that the federal policies were informed by the reality at the border.
The commission previously had a large office here in El Paso, the headquarters of the U.S. section. Now it has a much smaller space, and I understand no one has moved in. Among border health leaders, there is a sense that the U.S. is abandoned its side of the commission. What is the vision?
Because of completely purely administrative reasons, rent and buildings and all that, the commission moved to a new space. There is a staff. There are two people. The reason they haven’t been there is because of COVID and all the telework policies we have in the government. So by no means is the office abandoned.
This administration wants to strengthen the commission. There are many, many border health needs that are general to the health status of both countries, but there are considerations that are unique to the border. We have these massive populations that in reality are the same community. The vision is to definitely strengthen the commission. I want to give the commission a voice that perhaps it didn’t have the past four years.
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It seemed the work of the U.S. side of the commission stopped or slowed down very much during the past administration, and there has been concern about whether the commission was going to survive.
We have had a series of meetings. We’re now in a new process of bringing things that are happening at the border to the highest level of the department, which I also hear, like you’re saying, that didn’t happen before. I think that we’re doing good. It’s a shift in paradigm, but it’s actually what the law mandates and is asking the commission to do.
We put a lot of emphasis in the last four or five months in reshaping our side. And that’s why it took a little bit to sort of put our act together in this new way of functioning. We had the bilateral meeting with Mexico, the planning meeting, and we are going to move in the direction of having later on this year the annual meeting.
Is the commission fully staffed?
The commission is fully staffed except for one state, Arizona, where we only have one special government employee. And we are in the process of having Arizona nominating someone. But other than that it is fully staffed on the U.S. side.
The commission saw its budget decline during the Trump administration. Could you explain the decline in overall funding, as well as the sharp decline in funding for cooperative agreements?
Right, right. Exactly. So you probably see the budget figures, and you know that that big drop in budget for cooperative agreements happened during the previous administration. So I don’t want to comment a lot on decisions that were done prior to me. All I know is that there was that desire from the commission already to play this advisory role and have less of a footprint on managing grants.
A lot of it is because of conflict of interest; these (commission) members from the states were advising on programs that were going to the states. So to keep the lines clean, I think some of the decisions were based on that.
There is still funding for cooperative agreements that go through the (Centers for Disease Control) BIDS program, the Biological Infectious Disease Surveillance program. We had a great discussion two weeks ago about all the things that were done during COVID — from pilots to test agricultural workers and see the impact of COVID, to mobility of migrants across the border, to studies to start understanding the vaccination rates of people crossing the border.
Now with this renewed focus of the commission, the commission has a say as an advisor on what areas should be funded. So there is a conversation between the commission and the BIDS officers to say, ‘Okay, these are the areas that we need to refocus the funding on.’
What are your short-term goals for the commission?
We’re going to start working on a national meeting. And the big decision is to redo or redevelop the Healthy Border 2030 document. There was commitment on both sides that this will be the road map for what the authorities on both sides of the border have to focus on to address border health issues. This time we will take a little bit of a different approach. It will be a very high-level executive document that can go to congresses on both sides, to ministers of health, to security authorities to say, ‘These should be your 10 top priorities in the next year.’
We’re also working on lessons learned (from COVID-19).
There are lessons that are very, very specific to border communities, especially with all the border closures and with the supply chain, and, you know, with the health system capacity on both sides; diagnostics; vaccine requirements. So there are a lot of things that are very specific to the border that we want to make sure I capture and elevate to the federal authorities.
You’re in Mexico City. Are we going to see the the headquarters or the directorship move back to the border?
Definitely, there’s no plan whatsoever to eliminate the El Paso office. I know our Texas colleagues are very keen on keeping the El Paso office there. We have all intention to strengthen it. We definitely want to keep the office there. But we need to make sure that when we fill that position permanently, we have a person there that can understand both: the border and the federal government.
Lauren Villagran can be reached at lvillagran@elpasotimes.com.
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