n Results 4.1.2.4.4 Information Sharing as a Function of the Network
An effective regional collaboration always starts with sharing, be it of information, specimens, or resources. For MBDS, cross-border information sharing is the most important element in the development of a more efficient disease surveillance and response system along country borders. Borders between the Mekong countries have been recognized as entry points for diseases and as mentioned elsewhere, borders possess all the necessary prerequisites for effective disease transmission. Thus, cross-border information sharing has been a core strategy for the network since its inception in 1999. Information sharing along these borders will enable early detection of an outbreak, whether impending or actual, and will allow for an early response that can reduce morbidity and mortality due to disease. In the DSN Initiative, the cross-border information sharing was expanded to cover new cross-border sites in the six countries. More sites are committed to sharing information relevant to disease surveillance and response. An increase in cross-border site-sharing information means an increase in the area with access to relevant information. This will trigger RRTs organized and trained to react in a timely and appropriate manner. Disease Surveillance Networks Initiative 48
An agreed-upon mechanism and frequency of exchange is in place. The information exchange occurs at the provincial level through official lines of communication. The section on MBDS as a project describes the current status of information exchange. The number of functional cross-border sites that adhere to the agreed-upon mechanisms of exchange is higher than those that do not follow these mechanisms. A number of cross-border sites do not follow the mechanisms of exchange, while others implement information exchange in an irregular fashion by sharing information only during joint cross-border meetings. Reasons for lapses in information exchange can include communication-technology issues, inadequate human resources, and differing country policies, such as policies that could prevent a case from being shared. In some countries, a case is only defined as one after a confirmatory test—requiring that more time pass before the event/case can be shared. In other countries, a case is defined based on a syndrome or a symptom which makes it easier to share information earlier. As mentioned, the official cross-border information exchange takes place at the level of the province and should be made by the provincial site coordinator. However, because of the trusting relationship that border officials have established, informal or unofficial exchange takes place earlier to ensure faster real-time sharing in a significant number of cross-border sites. Informal exchange mostly occurs in cases of diseases on high alert, such as H5N1 and