On Jan. 22, the United States initiated withdrawal from the World Health Organization. Since then, several Democratic-led states, including Illinois, have expanded their global-health partnerships. These actions have created friction with federal policy, straining the relationship between the states and the federal government and contributing to a broader legal standoff about CDC funding cuts.

President Donald Trump’s executive order to withdraw the U.S. from the WHO was based on several reasons centered on accountability, fairness, and national interest. 

Health and Human Services Secretary Robert F. Kennedy Jr. and Secretary of State Marco Rubio said in a joint statement that the decision was meant to right injustices and end the “bureaucratic inertia” and “international politics” that have damaged the WHO.

One of the critique points is the disproportionate share of the administration’s financial burden borne by U.S. taxpayers compared to other major powers, notably China. Conversely, WHO and UN spokespeople have pointed out that the U.S. still had an outstanding financial obligation of about $260 million at the time of exit — a debt the Trump administration has explicitly said it does not intend to pay.

On Feb. 3, 2026, Illinois Gov. JB Pritzker issued a formal press release to Illinois residents and the broader public health community about Illinois joining WHO’s Global Outbreak Alert and Response Network, or GOARN. Illinois is the second U.S. state to join GOARN, following California. 

GOARN is a WHO-coordinated partnership responsible for handling international public health emergencies — stopping the spread of diseases across borders by providing real-time outbreak intelligence, sharing expert laboratory data and rapidly deploying multidisciplinary teams of specialists to assist affected countries. 

Pritzker’s announcement emphasized the effort to “put science, preparedness and people first,” signaling that the Illinois Department of Public Health would remain directly connected to international experts and real-time outbreak intelligence.

California Gov. Gavin Newsom’s primary reason for joining GOARN was to counter what he termed a “reckless decision” by the Trump administration to withdraw the U.S. from the WHO, according to Reuters.

“California will not bear witness to the chaos this decision will bring,” Newsom said. “We will continue to foster partnerships across the globe and remain at the forefront of public health preparedness.”

Since Feb. 3, New York state and New York City have also joined the network.

While joining GOARN may seem violate the Compact Clause of the Constitution, legal scholars suggest that the state is operating in a distinct legal gray area.

“Under international law, a treaty is defined as an agreement between two states, and states in the sense of nation-states,” said Cindy Buys, a Professor at SIU’s School of Law. “That’s not what the WHO is.”

Buys explained that by framing the agreement as a technical partnership rather than a binding pact, Illinois avoids constitutional violations.

 “It isn’t a treaty that the state of Illinois would be entering into with a foreign government, but instead, they’re just agreeing to attend meetings and share information,” she said.

John Shaw, Director of the Paul Simon Public Policy Institute, provides a different perspective.

“I do not see this as an attempt to establish an independent Illinois foreign policy, but rather as an effort by the governor to try to protect the public health of the people of Illinois,” Shaw said.

 “It is also clearly a message by the governor that he will attempt to resist those administration policies that he believes are potentially hurtful to his state.”

The states that have joined GOARN enjoy several benefits — no membership fees, early-warning alerts through direct and real-time access to global intelligence on emerging disease threats, expert collaboration with international experts, and the ability to request technical and personnel assistance from the network during a local health emergency.

Illinois faces the danger of conflicting guidance from the WHO and the CDC in case of a disease outbreak. While Illinois and California have passed laws allowing them to follow independent medical organizations, the legal reality is murky.

“We have a supremacy clause in the Constitution, which says that federal law is supreme over state law,” Buys said. 

According to Buys, “states also have their own police powers under our federalist system,” creating a complex legal landscape where “some decisions are made at a state level and some that are made at a federal level.”

“Gov. Pritzker has clashed with the Trump administration on many issues and neither the governor nor the Trump White House is likely to back down,” Shaw said.

As Trump moves to cut $600 million in CDC grants intended for HIV prevention, COVID-19 health equity initiatives, and programs for marginalized communities, Manish Shah, a federal judge in Chicago, on Feb. 12, issued a 14-day temporary restraining order for the cuts. 

The move was intended to shift federal policy away from efforts that “do not reflect agency priorities”, according to the Trump administration, and targets four Democratic-led states — Illinois, California, Colorado and Minnesota. 

According to Illinois officials, including Attorney General Kwame Raoul, if the cuts go into effect, Illinois would stand to lose over $100 million in critical CDC funding, with over $30 million associated with HIV, hepatitis, STI, and TB prevention.

Regarding the $600 million in rescinded grants, the legal battle centers on whether the White House can withhold money Congress already approved — a concept known as impoundment.

“The courts have said that the President does not have the power to impound the funds the way that he has done,” Buys said. “We don’t have a final resolution on that issue from the courts yet.”

Southern Illinois relies on Federally Qualified Health Centers, unlike Chicago, and the cuts could lead to the closure of rural clinics.

While Illinois has secured immediate access to global health data through the WHO, it must now contend with the loss of the federal funds needed to act on that intelligence.

It is a political standoff that Shaw warns will have consequences far beyond the Governor’s mansion.

“I do not see southern Illinois as a political orphan … I expect the bulk of the administration’s funding and policy retaliations will be targeted at the state’s urban communities,” Shaw said. “There is likely to be collateral damage that will impact the entire state.”

Staff Reporter, Trevor John, can be reached at [email protected]

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