The Pacific NorthWest Border Health Alliance (PNWBHA) is a cross border collation of: the states of Alaska, Idaho, Montana, Oregon and Washington; the provinces of Alberta, British Columbia and Saskatchewan; and the Yukon Territory. The State of North Dakota  and the Provinces of Alberta and Manitoba have also been invited to participate. PNWBHA’s primary goal is to provide leadership in the integration of  health sector preparedness and response initiatives at all levels of government, including Tribal and First Nations, throughout the Pacific Northwest.
The Pacific NorthWest Border Health Alliance is a member of the CA-US Pan Border Public Health Preparedness Council



In 2004 British Columbia and Alberta signed a Memorandum of Understanding (MOU) with respect to collaboration on the use of available public health and health services resources during emergencies. A similar memorandum of understanding was signed between British Columbia and Washington State in 2006.
Since 2004 the Washington State Department of Health and the British Columbia Ministry of Health Services have jointly sponsored an annual Pacific North West Cross Border Public Health Workshop on emerging public health issues, including pandemic influenza.  The eighth workshop is scheduled for May 24-26, 2010, in Victoria BC.
These workshops have reinforced the need to formalize existing informal communication/ collaboration through agreements or memorandum of understanding between public health partners, and a commitment was made to continue that work.  Participants agreed to undertake a collaborative approach around access to and use of available health service resources to prepare for, respond to and recover from public health emergencies. They also agreed that existing formal and informal agreements that support meeting such demands during emergencies need to be clarified to ensure a common understanding, and to explore possible new areas of joint collaboration.
To date cross border collaboration has enabled public health officials to discuss, and compare response plans, and build upon best practices developed in other jurisdictions in addressing issues as diverse as Norovirus, Lyme Disease, and Measles. The existing collaborative relationship can be strengthened and a common understanding can be reached by formalizing and extending existing informal communication networks through the creation of the Pacific North West Border Health Alliance.
Recognizing the need to institutionalize the informal partnership arrangement that had sustained the workshop, the 2008 Cross Border Public Health Workshop (Bellingham) endorsed the creation of a Pacific North West Border Health Alliance (PNWBHA).
A MOU  was been developed in response to this identified need.  The MOU provides a framework for further collaborative work, including mutual assistance and inter-agency and interdisciplinary collaboration.
The new alliance replicates the Pacific North West Economic Region (PNWER). Additional jurisdictions may be invited to participate if interest in participating is indicated.
This innovative agreement between the existing PNWER jurisdictions was intended to allow the region to respond to surge capacity demands on health systems and health resources efficiently and in a cost effective manner when public health emergencies arise in any PNWER jurisdiction. The arrangement also allows states-provinces to assess current and explore future areas of operational responsibility that could result in efficiencies when providing health services
The MOU creating the Pacific North West Border Health Alliance provides the framework for collaborative work, including mutual assistance and inter-agency and interdisciplinary collaboration in the Pacific North West.
In addition, the MOU provides a solid base upon which to pursue new and/or enhanced initiatives that:
  • strengthen existing prevention, detection and response capabilities, such as, improved coordination in responding to emergencies; enhanced laboratory diagnostic capacity and security; updating stockpiles of necessary vaccines, antibiotics and antidotes; and ensuring all participating jurisdictions have trained staff ready to respond to any crisis; and
  • promote coordinated response plans, particularly between bordering jurisdictions, to avoid duplication of efforts, fill in identified gaps, and maximize the leverage of limited resources