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Managing Borders During Public Health Emergencies of International Concern: A Proposed Typology of Cross-border Health Measures

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The near universal adoption of cross-border health measures during the COVID-19 pandemic worldwide has prompted significant debate about their effectiveness and compliance with international law. The number of measures used, and the range of measures applied, have far exceeded previous public health emergencies of international concern. However, efforts to advance research, policy and practice to support their effective use has been hindered by a lack of clear and consistent definition.


Based on a review of existing datasets for cross-border health measures, such as the Oxford Coronavirus Government Response Tracker and World Health Organization Public Health and Social Measures, along with analysis of secondary and grey literature, we propose six categories to define measures more clearly and consistently – type of movement (travel and trade), policy goal, level of jurisdiction, use by public versus private sector, stage of journey, and degree of restrictiveness. These categories are then be brought together into a proposed typology that can support research with generalizable findings and comparative analyses across jurisdictions. The typology facilitates evidence-informed decision-making which takes account of policy complexity including trade-offs and externalities. Finally, the typology can support efforts to strengthen coordinated global responses to outbreaks and inform future efforts to revise the WHO International Health Regulations (2005).


The widespread use of cross-border health measures during the COVID-19 pandemic has prompted significant reflection on available evidence, previous practice and existing legal frameworks. The typology put forth in this paper aims to provide a starting point for strengthening research, policy and practice.

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