Illinois and New York City Join WHO Outbreak Network After U.S. Withdrawal

A new route to Geneva

The videoconference tiles flickered to life on a recent weekday morning as epidemiologists from every continent logged into a regular briefing of the World Health Organization’s Global Outbreak Alert and Response Network, known as GOARN. On one screen, health officials in West Africa described an unusual cluster of hemorrhagic fever. On another, lab scientists in Europe shared sequencing data.

Amid the familiar mix of WHO staffers and national disease agencies, two newcomers appeared: the Illinois Department of Public Health and the New York City Department of Health and Mental Hygiene.

Their presence underscored a striking shift in how parts of the United States now plug into the global health system. Just weeks after the federal government completed its withdrawal from the World Health Organization, Illinois and New York City have independently joined GOARN, a WHO‑coordinated network that mobilizes experts and resources to detect and respond to outbreaks worldwide.

They follow California, which on Jan. 23 became the first U.S. state to join GOARN—one day after the U.S. withdrawal from WHO took effect.

Together, the moves mark the latest step in an unusual form of state‑ and city‑level diplomacy, as Democratic‑led jurisdictions seek to preserve direct ties to international health institutions even as Washington pulls back.

Illinois and New York City make their case

On Feb. 3, Illinois Gov. J.B. Pritzker announced that his state had been accepted into GOARN as a partner institution.

“By withdrawing from the World Health Organization, Donald Trump has undermined science and weakened our nation’s ability to detect and respond to global health threats,” Pritzker said in a written statement. “I refuse to sit idly by and let that happen. By joining the World Health Organization’s coordinated network, GOARN, we are ensuring that our public health leaders – and the public – have the information, expertise, and partnerships they need to protect the people of our state.”

Two days later, New York City’s health department said it, too, had joined the network, calling itself the first municipal health agency in the United States admitted to GOARN.

“New York City is a global city with 8.5 million residents and more than 12 million international visitors every year,” Dr. Michelle Morse, the city’s acting health commissioner and chief medical officer, said in a statement. “Infectious diseases know no boundaries, and nor should the information and resources that help us protect New Yorkers.”

The backdrop: a yearlong federal retreat

The flurry of announcements is a direct response to a yearlong federal retreat from the WHO.

On Jan. 20, 2025, President Donald Trump signed Executive Order 14155, beginning the process of withdrawing the United States from the U.N. health agency. The administration accused WHO of mismanaging the COVID‑19 pandemic and failing to enact reforms, and alleged that the organization was unduly influenced by some member states. Over the next year, the U.S. halted its funding and began pulling staff from WHO posts.

The withdrawal became official on Jan. 22, 2026, when Health and Human Services Secretary Robert F. Kennedy Jr. and Secretary of State Marco Rubio formally notified WHO that the U.S. relationship had ended.

WHO leaders expressed regret and warned that the decision would weaken global preparedness. The agency, which relied on the U.S. as its single largest donor, has since moved to cut its two‑year budget and eliminate roughly one‑fifth of its workforce, including hundreds of technical posts.

For Illinois, New York City and California, the concern is less about WHO’s internal politics and more about what information and support they might lose without a federal presence in Geneva.

What GOARN is—and why subnational agencies can join

GOARN, created in 2000, is one of the main engines of WHO’s emergency work. The network links more than 300 partner institutions, including national public health agencies, research institutes, laboratories, nongovernmental organizations and U.N. bodies. When an unusual cluster of disease emerges, WHO can convene GOARN partners, share data and deploy teams of specialists to help with investigation, diagnostics and control.

The network is governed by a steering committee of partner institutions and coordinated by a WHO support team in Geneva. It is not a treaty or a formal membership organization in the way WHO itself is. Instead, partners sign up as technical institutions willing to share information and, in some cases, staff and lab capacity.

That structure has opened the door for subnational agencies.

California’s Democratic governor, Gavin Newsom, seized the opportunity first. On Jan. 23, he announced that the state health department had joined GOARN, framing California as a global public health actor in its own right and casting the step as a direct answer to the U.S. withdrawal from WHO.

Illinois followed with its own bid. The state’s health department stressed that participation would keep Illinois “directly connected to timely global alerts, expert public health networks, and international response capabilities,” even without federal intermediaries.

“Disease knows no borders, and Illinois is taking decisive steps to strengthen our preparedness,” Dr. Sameer Vohra, director of the Illinois Department of Public Health, said in his agency’s announcement. “Joining the World Health Organization’s GOARN connects us to global experts, rapid alerts, and real‑time intelligence—essential tools for preventing and managing outbreaks.”

Pritzker’s administration has spent the past year positioning Illinois as a counterweight to shifting federal policy on vaccines and surveillance. In September, the governor signed an executive order directing state experts to issue immunization guidance “where federal actions fail to protect the public health,” and launched a vaccine access initiative that leans heavily on the state’s own advisers. Illinois is also part of the Governors Public Health Alliance, a coalition of 15 Democratic governors created in October to coordinate policy and data sharing as the federal government steps back from some traditional roles.

New York City’s health department is making a similar argument for going directly to Geneva.

City officials point to the agency’s scale and experience. DOHMH oversees surveillance for more than 90 infectious diseases, runs a health alert network that can reach tens of thousands of clinicians within hours, and has led responses to outbreaks ranging from Zika virus to measles to COVID‑19 and mpox.

The department said GOARN membership will give it access to weekly meetings on international health issues and direct channels to global partners during high‑risk periods, including major events such as the 2026 FIFA World Cup, which is expected to draw large numbers of international visitors through New York area airports.

“Infectious disease threats overseas can become local problems in a matter of hours,” Morse said. “Being part of GOARN strengthens our ability to see those threats early and to coordinate with counterparts around the world.”

Legal and political questions—and what comes next

Health law scholars say the arrangements are unusual but not necessarily unlawful. States and cities have long joined technical and professional networks with international partners, particularly in areas such as climate policy, policing and public health. The U.S. Constitution reserves foreign policy and treaty‑making to the federal government, but GOARN is a voluntary, nonbinding partnership focused on technical cooperation.

“There is a gray zone between foreign policy and technical collaboration,” said one professor of health law and policy who has studied multilevel governance. “What California, Illinois and New York City are doing is clearly meant to preserve international ties that the federal government has chosen to sever, but they’re doing it in a space—outbreak surveillance and response—that has traditionally been within state police powers.”

So far, the Trump administration has not publicly challenged the GOARN partnerships. The Department of Health and Human Services has emphasized that the U.S. will pursue “alternative arrangements” for global health cooperation outside the WHO system, but has provided few details.

A fragmented U.S. preparedness landscape

The emergence of state‑ and city‑level links to GOARN highlights a broader fragmentation of U.S. public health infrastructure.

Jurisdictions that join GOARN or similar networks will have access to early technical briefings and, potentially, international surge teams if they face a major outbreak. Others—particularly in states that do not participate in Democratic‑led alliances or lack resources to build their own global relationships—may depend primarily on federal channels that are still being redefined.

That could create a two‑tiered system of preparedness within the same country, with faster, more detailed information flowing to some communities than others.

At the same time, the moves keep significant American technical capacity inside WHO‑coordinated operations at a moment when the agency’s overall resources are shrinking. Illinois, California and New York City bring high‑volume laboratories, genomic sequencing capabilities, wastewater surveillance and experienced outbreak investigation teams to the table.

For WHO, which has lost its largest state donor but remains responsible for coordinating responses to Ebola, cholera, avian influenza and other threats, having U.S. subnational partners inside GOARN may ease some of the operational blow of Washington’s departure and preserve relationships that could matter if a future administration seeks to rejoin.

A changing global picture

Back on the GOARN briefing call, the names on the screen offer a condensed picture of the changing global order: national health ministries from Africa and Asia, specialized labs in Europe, a state health department from California, the public health agency of Illinois, and, now, the New York City health department.

They do not speak for the United States as a nation. But in the race to spot and stop the next outbreak, they are increasingly representing tens of millions of Americans in a room where, for the first time in decades, Washington itself has chosen not to sit.