California has become the first U.S. state to formally join a World Health organisation–coordinated global outbreak response network, marking a significant development in international public health engagement at a time when the federal government has withdrawn from the agency. The move follows the decision by the administration of President Donald Trump to end U.S. participation in the World Health Organisation, citing disagreements over the agency’s handling of the COVID-19 pandemic and broader concerns about governance and accountability. Against this backdrop, California officials have taken steps to maintain access to international disease surveillance systems and outbreak coordination mechanisms that were previously supported through federal involvement.
The announcement came after Governor Gavin Newsom met with WHO Director-General Dr. Tedros Adhanom Ghebreyesus during the World Economic Forum in Davos, Switzerland, held from January 19 to January 23, 2026. During the meeting, the two discussed collaboration on monitoring and responding to emerging public health threats. Shortly afterwards, California confirmed that it had joined the Global Outbreak Alert and Response Network, known as GOARN, a WHO-coordinated partnership that connects public health institutions, laboratories, academic centres, governments, and response organisations across the world.
GOARN was established in 2000 following a series of international health emergencies that exposed weaknesses in global coordination and information sharing. The network now includes more than 350 partner organisations and focuses on the early detection, verification, and response to infectious disease outbreaks and other public health emergencies, particularly those with cross-border implications. Participation involves regular briefings, data sharing, and coordination calls, as well as access to outbreak intelligence platforms managed by WHO.
California’s entry into the network comes as the United States government has confirmed that it will no longer take part in WHO-led or WHO-managed events. In a statement provided earlier this month, the U.S. State Department said the federal government would not continue participating in groups such as GOARN. The Department of Health and Human Services has stated that the United States intends to pursue bilateral health and aid agreements directly with individual countries, rather than engaging through multilateral organisations, and emphasised that states do not set U.S. foreign policy.
Governor Newsom said California’s decision was driven by public health considerations following the federal withdrawal. In a statement, he said the state would continue to engage with global partners to support public health preparedness and outbreak response. The governor’s office described California as the first and currently the only U.S. state to join the WHO-coordinated network, positioning the move as a continuation of the state’s efforts to maintain international public health linkages.
Dr Erica Pan, director of the California Department of Public Health, confirmed that state health officials have begun participating in GOARN’s regular coordination calls. These calls, which take place weekly, focus on health emergencies worldwide and were previously attended by representatives of the U.S. federal government. Pan said California’s participation provides access to real-time outbreak updates and analytical tools, including the WHO’s Epidemic Intelligence from Open Sources platform, which continuously scans global public sources for signals of emerging health events.
According to Pan, California is currently undergoing onboarding and training to fully integrate into the network’s information-sharing systems. She said access to global outbreak data allows the state to assess potential risks earlier and adjust public health responses accordingly. State officials have also pointed to a reduction in federal public health guidance in recent months, including the absence of a national influenza vaccination campaign during the current flu season, as a factor influencing California’s decision to seek alternative information channels.
The move has drawn attention from other states. Pan said she has been in contact with health officials in several states that have expressed interest in joining GOARN or similar international frameworks. Illinois has issued a public statement indicating that it is making preparations to join the network. However, WHO participation rules limit full membership to national governments, meaning that states can only engage through specific programs that allow non-national entities, such as GOARN.
Public health experts have described California’s participation as part of a broader trend of states assuming a more active role in areas traditionally coordinated at the federal level. Dr Gavin Yamey, a professor of global health and public policy at Duke University, said the decision reflects growing state-level involvement in international health engagement following changes in federal policy. He noted that access to global outbreak data remains an important component of public health preparedness.
Not all responses have been uniformly positive. Some policy analysts have questioned the scope and long-term implications of California’s role in the network. Brett Schaefer, a senior fellow at the American Enterprise Institute, said it remains unclear how WHO will define California’s status within GOARN and whether the arrangement will have practical effects beyond information sharing. He also said the federal government could continue to access certain outbreak intelligence platforms independently of WHO membership.
WHO has not publicly commented on California’s participation or on inquiries regarding interest from other U.S. states. The organisation has also not clarified whether additional state-level entities may be admitted to GOARN under similar terms. GOARN’s existing membership includes a wide range of institutions, including national public health agencies, research institutes, humanitarian organisations, and international laboratories.
California officials have stated that the state intends to share relevant information obtained through GOARN with other states that are not members of the network. Pan said California’s goal is to provide coordination and support, particularly given the size of its public health infrastructure. California operates the largest state health department in the country, serving a population of nearly 40 million people.
In October, Newsom joined governors from 14 other states to launch the GGovernors’Public Health Alliance, a nonpartisan organisation designed to improve coordination among states on emergency preparedness, data sharing, and public health communication. The alliance was created to facilitate consistent responses to emerging health threats and to support collaboration across state and territorial boundaries.
California has also taken part in regional public health coordination efforts. Last year, the state joined Oregon, Hawaii, and Washington in forming the West Coast Health Alliance. The partnership focuses on aligning health guidelines and immunisation recommendations based on guidance from national medical organisations. State officials have said the aim is to provide consistent recommendations to residents across the region, particularly during periods of changing federal guidance.
In September, Governor Newsom signed Assembly Bill 144 into law. The legislation authorises California to base its immunisation guidance on recommendations from independent medical organisations rather than the Advisory Committee on Immunization Practices, which advises the CDC. On the same day the bill was signed, the West Coast Health Alliance released coordinated vaccination recommendations for the 2025–26 winter virus season, covering COVID-19, influenza, and respiratory syncytial virus.
California’s participation in GOARN does not confer voting rights or formal decision-making authority within WHO, which remains limited to member states. However, state officials say the arrangement allows California to remain connected to global surveillance and response systems at a time when federal engagement has been reduced. GOARN has previously supported international responses to outbreaks, including SARS, Ebola, and mpox, by coordinating field deployments, data analysis, and logistical support among partner organisations.
The federal government has reiterated that it does not intend to reverse its withdrawal from WHO or resume participation in WHO-managed programs. In statements to media outlets, federal officials have emphasised that international health engagement will continue through bilateral channels and domestic public health institutions. The administration has maintained that this approach prioritises national oversight and accountability.
