Findings: Most participants (93%) suggested a systems level approach is required. The second most suggested strategy with 63% of participant support was sensitizing border leaders of the reality of issues in the area. Participants (46%) also suggested networking and media advocacy (40%) strategies as more important than the inclusion of priority audience (23%) or the proper allocation of resources (23%). Conclusion: In review of many current border health issues, there are significant gaps where a clear, shared vision is yet to emerge. When a common vision is well developed in a group or population, that is when genuine cooperative actions foster health policy development.