The WHO Country Office for Nepal, with technical support from the WHO South-East Asia Regional Office (SEARO), convened a two-day cross-border capacity-building training for Surveillance Medical Officers (SMOs) from Nepal and India (bordering Bihar, India), in Biratnagar, Koshi Province on 17–18 November 2025. A similar training for SMOs of Nepal and India bordering Uttar Pradesh of India was conducted in Gorakhpur, India, from 13–14 November 2025. Nepal shares 1751 km of porous border with India.
In line with WHO South-East Asia Regional Immunization Technical Advisory Group (SEAR-ITAG) recommendations, the training aimed to strengthen preparedness for priority vaccine-preventable disease (VPD) outbreaks and reinforce mechanisms for cross-border collaboration, an essential component of regional health security.
The meeting brought together 28 participants in both training sessions. Opening the meeting, Dr Vinod Kumar Bura, Coordinator for Immunization and Vaccine Development at WHO SEARO, highlighted the importance of cross-border collaboration and outlined the objectives of the sessions. Technical sessions were led by experts from WHO SEARO, WHO Nepal, and WHO India, including Dr Sudhir Khanal, Regional Advisor for Accelerated Disease Control; Dr Balwinder Singh, Team Lead of Immunization Preventable Diseases Programme at WHO Nepal; and other senior WHO staff from both countries.
The first day featured technical sessions on outbreak preparedness, including simulation exercises and an overview of the WHO Emergency Framework and VPD outbreak readiness assessment. SMOs from India and Nepal discussed on cross-border collaboration mechanisms. WHO India delivered a presentation on the standard operating procedures for responding to poliovirus events and outbreaks. WHO Nepal also presented a step-by-step approach to measles outbreak preparedness and response.
The second day focused on tabletop simulation exercises involving cross-border measles and polio outbreak scenarios. Four groups were formed comprising of SMO from bordering districts of India and Nepal. Thirteen SMOs (8 from India and 5 from Nepal) worked through outbreak detection, investigation, response and recovery processes. Each exercise concluded with a structured reflection session (“HOTWASH”). Participants identified priority areas for collaboration and shared lessons learned from recent public health events.
Both countries shared updates on their polio transition plan status and its implications on VPD surveillance and outbreak response. Participants agreed that integrating VPD surveillance into national health systems can strengthen health security and advance broader health goals.
The meeting recommended formalizing cross-border coordination mechanisms between International Health Regulations 2005 (IHR 2005) teams and immunization programs, strengthening collaboration between government authorities of two countries, prioritizing regular information sharing, and mapping of vulnerable areas and Points of Entry (PoEs) for early detection and synchronized response. Strengthening PoE capacities, regular communication between SMOs from bordering districts of India and Nepal and conducting biannual SMO meetings were highlighted as critical next steps.