Abstract
Abstract Veterinary border quarantine intercepts pathogens before they enter domestic livestock populations, yet in most low- and middle-income countries (LMICs) it continues to be treated as an administrative compliance formality rather than a strategic investment priority. This review synthesizes regulatory, operational, epidemiological, and institutional evidence to critically examine how veterinary border quarantine functions in LMIC settings, why persistent structural gaps constrain its performance, and what modernization pathways are realistically available. Evidence was identified through a purposive, iterative narrative synthesis of the peer-reviewed and institutional literature, supplemented by official documents from the World Organisation for Animal Health, the Food and Agriculture Organization, the World Health Organization, and the World Trade Organization. Across the evidence examined, quarantine underperformance in LMICs is driven less by the absence of international technical standards than by weak governance independence, thin diagnostic and veterinary workforce capacity, fragmented data systems, and the structural dominance of informal cross-border trade that formal inspection points do not reach. Emerging tools, including portable diagnostics, digital certification, and risk-based targeting, show measurable benefit in higher-resource settings but remain largely unvalidated under LMIC field conditions, a specific evidence gap this review identifies rather than resolves. Reframing veterinary border quarantine as strategic One Health infrastructure rather than administrative overhead offers a defensible basis for prioritizing investment, though this reframing is conceptual and has not yet been tested against comparative financing outcomes across countries. Geographic coverage in the underlying literature remains uneven, with evidence concentrated in a smaller set of well-documented countries and settings, a limitation of the underlying evidence base that this review acknowledges directly.