Quality of life in the US-Mexico border communities is built not only upon commerce, tourism, and a host of comparative advantages, but also on a network of diplomatic and epidemiological collaborative efforts to safeguard health at community, regional, and national scales.

In this paper, we turn our attention to infectious diseases by focusing on the bilateral response to the 2009 H1N1 pandemic. There are three principal reasons for this. To begin with, the enormity of the COVID-19 outbreak, its impact on public health and the economy in 2020, and the ensuing North American response (of which a partial border closure has been a key policy lever) inevitably draws attention to the 2009 H1N1 pandemic for lessons learned. Another reason is that a region with such broad and deep health challenges as the US-Mexico border region faces particular danger from pandemics, which often arise suddenly and prey on populations with underlying health issues. Finally, the bilateral response to the 2009 H1N1 pandemic stands out as a particularly well-defined example of cross-border US-Mexico cooperation on an urgent public issue, like pandemic response. Bilateral cooperation to address issues at the complex and misunderstood US-Mexico border region lies at the heart of The State of the Border Report in 2013 and now again in 2020. 

This paper comprises a set of interviews with key actors from 2009 who saw the diplomatic, operational, technical, and other dimensions from a particularly strategic position. Their recollections of a unique moment of urgency in North American and crossborder collaboration show us the value of preparation, confidence-building, collaboration, coordination, and institution-building across multiple federal, state, and local agencies in North America. 

This paper forms part of The State of the Border Report 2020. The report's chapters will be released as individual papers throughout 2020 and put together as a volume at the end of the year.