Abstract

This paper examines how sequenced cross-border health initiatives may contribute to confidence-building and, ultimately, serve as catalyst toward more coherent cross-border migration-related governance in North Africa. Using a practice-based case study approach, it analyzes a series of regional processes implemented in 2024 and 2025 by the International Organization for Migration (IOM), in collaboration with the WHO Regional Office for the Eastern Mediterranean (WHO EMRO) and Africa CDC, including two technical workshops in Tunis, a sub-regional simulation exercise in Cairo, and a Mediterranean Forum. The analysis draws on process documentation, institutional outputs, and the authors’ direct involvement in these initiatives to trace how repeated technical engagement supported procedural alignment and the gradual building of confidence for cross-border collaboration. Key outputs included a draft operational plan, a technical white paper, and regional policy recommendations. The paper argues that, in politically sensitive migration settings, cross-border health cooperation—jointly engaging ministries of health, interior, and foreign affairs—can provide an entry point for dialogue, joint problem-solving, and confidence-building across countries and sectors, thereby enhancing collaborative governance. While such collaboration does not directly determine migration policy, it may contribute to health diplomacy efforts that foster a more coherent governance environment capable of supporting safer, more orderly, and better-coordinated migration processes. Although several operational questions remain unresolved and more studies are need it, this paper seeks to open further dialogue and encourage new evidence and reflection on the potential role of health as a catalyst for collaborative governance and confidence-building between countries.

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