Challenges

The border areas of MERCOSUR face structural challenges in ensuring equitable access to health services, epidemiological surveillance, and coordinated responses to public health emergencies. These weaknesses are compounded by the absence of joint operational mechanisms between countries, which undermines the effectiveness of actions to address transnational risks. The project aimed to bridge these gaps through regional technical cooperation, the use of national capacities, and the implementation of integrated actions in surveillance, vaccination, emergency networks, and preparedness. Achieving sustainable progress requires strengthening institutional coordination, consolidating binational coordination mechanisms, and ensuring the political and technical continuity of interventions. This initiative contributed to the achievement of SDG 3 (Good Health and Well-being) and SDG 17 (Partnerships for the Goals), by promoting resilient, equitable, and interconnected health systems in historically underserved territories. 

Toward a Solution

In response to persistent public health challenges in MERCOSUR border areas, the member countries—Argentina, Brazil, Paraguay, and Uruguay—joined efforts to design and implement a coordinated response. The main objective of the initiative was to strengthen health capacities in border territories through joint actions aligned with the Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being), SDG 17 (Partnerships for the Goals), and their targets related to resilient systems and regional cooperation. 

The project was structured around four strategic objectives: 1) strengthening epidemiological surveillance, 2) improving vaccination coverage, 3) assessing emergency and urgent care networks, and 4) preparing territories to respond to future health emergencies. A participatory approach was used, whereby technical teams from the health ministries of the four countries jointly planned and implemented the activities, prioritizing the use of existing national capacities and avoiding external dependency. 

For epidemiological surveillance, binational technical meetings were held, institutional capacity maps were prepared, and basic training was provided to local actors. Although no consultants were hired nor tutors trained, progress was made in designing a digital platform and a pilot plan, which will be resumed in the next phase. 

In terms of vaccination, the project successfully carried out binational campaigns, joint activities during the MERCOSUR Vaccination Week, and coordinated target planning, strengthening technical and operational coordination on the ground. 

In the area of emergency and urgent care, progress was made in mapping available resources and drafting preliminary joint response protocols. 

Finally, the health emergency preparedness component was fully implemented, including training sessions, binational drills, and the development of joint response protocols. 

The innovation of this good practice lies in the model of shared governance and decentralized activity management, which allowed interventions to be adapted to local realities while maintaining regional coherence. 

Furthermore, the strategy helped improve the health competitiveness of the involved territories by reducing epidemiological vulnerabilities in historically underserved areas. 

 The project was officially recognized by the MERCOSUR Meeting of Health Ministers (MERCOSUL/RMS/ATA Resolution No. 03/23) and received high-level political support at the presidential summit in December 2023. 

This recognition not only validated the effectiveness of the adopted approach but also motivated the development of a new joint proposal for the 2024–2025 period, focused on consolidating the achievements and ensuring the institutional sustainability of the actions. 

 The initiative demonstrated a high degree of replicability, having been implemented in various border contexts with different epidemiological and administrative characteristics. 

The conditions that enabled its success include strong regional political commitment, the presence of well-established technical teams, and the strategic support of organizations such as PAHO/WHO. 

These conditions must be maintained and reinforced to ensure continuity of results in the medium and long term. 

 Among the lessons learned, the need for agile coordination and execution mechanisms stands out, as well as the importance of planning actions with flexible frameworks that can adapt to constantly changing local contexts. 

 The project also demonstrated that South-South cooperation is not only viable but represents an effective path to addressing transnational health challenges that no country can solve alone.