Objective To understand the current situation of the prevention and control capabilities of sudden acute infectious diseases in health institutions in border and coastal provinces along the Belt and Road within China, thereby providing a basis for formulating prevention and control policies for these diseases.

Methods Considering factors such as geographical regions, cross-border population flows, international trade activities, and historical risks of imported infectious diseases, a questionnaire survey was conducted in May to September 2019 for the health institutions of seven border or coastal provincial-level administrative regions: Inner Mongolia autonomous region, Liaoning province, Xinjiang Uygur autonomous region, Yunnan province, Guangxi Zhuang autonomous region, Guangdong province, and Fujian province, from the 18 important provincial-level administrative regions in Vision and Actions on Jointly Building Silk Road Economic Belt and the 21st-Century Maritime Silk Road. A total of 105 health institutions, encompassing 35 health administrative departments, 35 disease prevention and control institutions, and 35 medical institutions, filled out the questionnaires, and the information related to the prevention and control capabilities of sudden acute infectious diseases in different institutions was collected and analyzed.

Results The prevention and control capabilities of sudden acute infectious diseases of health institutions at the provincial, municipal, and county levels in the border and coastal provincial-level administrative regions along the Belt and Road within China showed a decreasing trend depending on the administrative level. There were significant gaps in the prevention and control capabilities of sudden acute infectious diseases among health administrative departments and disease prevention and control institutions at different levels, and the capabilities of institutions at the county level was weak. The gap in the capabilities among medical institutions at different levels was small. The assessment revealed uneven development across functional domains. Emergency response systems, rapid response teams, surveillance and risk assessment, and medical treatment were the advantageous areas in the prevention and control of infectious diseases. However, policy planning, emergency resource allocation, laboratory testing, and international cooperation were the weak links.

Conclusions The prevention and control capabilities of sudden acute infectious diseases were weak in county-level health institutions of the border and coastal provincial-level administrative regions along the Belt and Road within China. It is necessary to focus on strengthening the capacity building at the primary level, particularly in key areas such as policy planning, emergency resource allocation, laboratory testing, and international cooperation.