Building Regional Capacity Across Borders: AUB’s Cross-Border Public Health Surveillance Course

Public health threats do not recognize national boundaries. Diseases can spread rapidly through travel, trade, migration, and environmental change, making it essential for countries to strengthen their emergency preparedness and response strategies and data sharing coordination. However, our regional assessment comprised of a literature review and interviews with health officials across the Middle East and North Africa (MENA), revealed gaps in cross-border collaboration, data exchange, and coordination mechanisms. These findings were published in the International Journal for Equity in Health and highlighted the need to strengthen the capacity of public health professionals to work across borders and sectors. In response to this need, we designed a course on Cross-Border Public Health Surveillance

In 2025, the Center for Public Health Practice (CPHP) at the Faculty of Health Sciences (FHS) at the American University of Beirut (AUB) in collaboration with the University of California, San Francisco (UCSF) and the U.S. Centers for Disease Control and Prevention (CDC), successfully completed the delivery of the pilot Cross-Border Public Health Surveillance Course. The course, the first of its kind in the Middle East and North Africa (MENA) region, was designed to equip graduate students and other professionals with the tools to cover detection, monitoring, and response to public health threats across borders. It included modules on One Health principles, emergency preparedness, health diplomacy, and surveillance of mobile populations into a comprehensive learning experience.

A Successful Collaborative Effort

The course was developed through months of collaboration between AUB, UCSF, and CDC, bringing together public health experts, epidemiologists, and policy specialists. Led by the AUB FHS teaching team comprised of faculty members from FHS centers like Center for Public Health Practice and Knowledge to Policy and FHS departments of Medical Laboratory Sciences, Epidemiology and Population Health, and Health Promotion and Community Health. They created a dynamic course that combined theory with real-world scenarios and practice.

Students worked through case studies on human rights and ethics, risk communication, mass gatherings, cross-border outbreaks, and the International Health Regulations (IHR). Guest speakers from across the MENA region joined to share first-hand experiences in managing public health challenges related to pilgrimage, emergencies, and border health systems, which added invaluable regional context to the academic content.

Despite Lebanon’s instability at the time, the team ensured the course ran as planned during the Spring 2025 semester. Sessions were delivered both in-person and online, maintaining an engaging and interactive learning environment.

“What stood out most was the extraordinary commitment of the AUB FHS CPHP team,” said Andrew Maher, UCSF, “Even as a months-long war in Lebanon unfolded during the middle of the project, the faculty and staff continued to show up for their students and for this collaboration with UCSF. Their dedication to maintaining academic excellence and international cooperation under incredibly difficult circumstances was nothing short of inspiring.”

Colleagues from CDC also highlighted the significance of this initiative for regional public health security. Zayid Al Mayahi emphasized the critical importance of the course for strengthening surveillance systems across borders “The need for cross-border surveillance knowledge and strengthened practices is immeasurable. This excellent academic course reflects the dedication, determination, and successful joint efforts of AUB, UCSF, and CDC. It also paves the way for more focused topics and future enhanced versions, advancing both surveillance efforts and potential effective interventional measures.”

Dana Schneider echoed this point, noting the global relevance of the course content: “In our highly connected modern world, diseases can spread from one corner of the globe to another in a matter of days. All countries, therefore, must have capabilities to address public health risks associated with the movement of people, animals, and goods, whether for short or long distances. This collaboration with AUB FHS, UCSF, and CDC will contribute to equipping future public health leaders in the region with knowledge about the health risks associated with mobility and the actions needed to limit cross-border disease spread. Such actions enable more effective public health responses, resulting in fewer disease outbreaks, faster resolution, and an overall healthier world.”

Integrating Practice Into Learning

The pilot course adopted a hands-on, evidence-based approach. Students participated in discussions, quizzes, group projects, and case studies, applying surveillance frameworks to simulated regional challenges. An extensive evaluation process, based on the RE-AIM conceptual framework, was conducted in three phases: baseline to midline and endline surveys to capture changes in students’ knowledge, engagement, and confidence. Both students and instructors reflected positively on the experience.

According to the evaluation report, even with a small cohort completing the course, the results were impressive:

• Students showed measurable improvements in knowledge and practical understanding of surveillance among mobile populations, risk communication, and points of entry.
• Engagement levels remained high with full attendance and active participation despite the demanding academic calendar. Students felt the course contributed meaningfully to their academic and professional development, noting that the new concepts introduced were valuable enhancements that strengthened and expanded their existing knowledge base.
• Instructors appreciated the course design, noting its strong relevance to real-world regional needs.

One student shared that the course ” offered a holistic and interesting insight into different levels and aspects of health surveillance.” Another student expressed that the course was “Very practical, as it gave me a new perspective on addressing certain Public Health challenges and emergencies especially” One student also highlighted the importance of the practical information in the course expressing that “this is one of the best things about the course”

Delivering this new course amid Lebanon’s economic and political instability came with a lot of challenges. Low student enrollment, financial barriers, and scheduling pressures during the spring semester all affected the cohort joiners. However, these challenges offered important lessons. The AUB FHS team responded by revising course content, shortening lecture durations, and exploring alternative delivery formats, including hybrid models and extensive workshops, to better suit both students and other professionals.

Next Steps: From Pilot to Regional Impact

The success of the pilot received interest from institutions across the region. Building on evaluation findings, AUB FHS refined the course to make it more accessible and replicable. Plans are already underway for:

• A revised course offering at AUB in the upcoming academic year
• A professional workshop on Cross-Border Public Health Surveillance to be delivered for PH professionals both in online format and in-person
• Sharing of the curriculum with other regional universities and training centers interested in adopting it and providing needed support to ensure smooth implementation.

This initiative represents a step toward strengthening regional public health preparedness through academia. AUB FHS, UCSF, and CDC will continue to build on this foundation with the aim to empower the next generation of public health professional in the MENA region to think and act beyond borders.

The AUB team emphasized the importance of this regional initiative in advancing public health preparedness. As noted by Martine Najem “This initiative brought together a diverse, multidisciplinary team of faculty and regional experts, offering students contextualized, hands-on learning grounded in country experiences. Despite funding uncertainties in the global ecosystem, engagement with regional and global stakeholders was highly positive and opened pathways for future expansion. We are grateful for the unconditional support and collegial exchange by USCF and CDC colleagues. All along the various phases of this partnership, and despite the highly challenging circumstances, we felt as one team working hand in hand with a unified vision to achieve a common objective of strengthening cross border public health surveillance in the MENA region.”