Surveillance; syndromic; border; binational; Mexico Novel conceptual framework and toolset for countrywide assessments of opportunities and challenges for public health interventions Introduction Imbalances in wealth, education, infrastructure, sociopolitical leadership, healthcare and demographics create opportunities and challenges when implementing public health interventions. Understanding these, while embracing 'smart power', one can objectively assess a country's receptivity for support. Therefore, we developed a novel conceptual framework and toolset that objectively measured opportunities and challenges to inform decision-making, specifically about future implementation of the Electronic Integrated Disease Surveillance System (EIDSS)*a computer-based system for national reporting and monitoring of reportable human and veterinary infectious diseases*in East Africa and the Middle East.