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Research on international borders in international law and relations has been dominated by the paradigm of state sovereignty, with an empirical focus on the politics of division and settlement. This article argues that if we take the idea of international borders seriously, we need to reexamine state obligations regarding how they are governed. New evidence is evaluated to assess the proposition that when borders are securitized unilaterally, human rights are at greater risk. Specifically, we assess whether and how evidence of border hardening is associated with growing differentials in health outcomes in border zones. We hope to open a new research agenda that documents and explains the varying ways in which the choice of border governance mode implicates human rights risks. In contrast to the other papers on this panel, we call for (rather than review) new cooperative governance modes that might preserve border security while minimizing the risks of violating human rights where mobile populations are often most vulnerable: in borders zones.