Every week, a World Health Organization network of more than 360 institutions holds a call to talk about emerging disease threats around the globe. Topics might include, say, new cases of the deadly Nipah virus in India, or a new mpox strain found in Great Britain.
The idea is to give public health agencies worldwide a heads up on diseases that may have popped up in one place but, thanks to the ease of international travel, could soon be making an appearance at an airport near you. Ever since the United States government finalized its divorce from the WHO earlier this year, though, the U.S. is no longer on those calls.
Now, Colorado is working to get back into the group. Gov. Jared Polis announced this month that the state has applied for membership in the network, known formally as the Global Outbreak Alert and Response Network, or GOARN.
“Diseases don’t stop at borders,” Polis said in an interview. “What we want to do in Colorado is say we still understand that somebody could get on a plane in Europe or Asia and bring a disease here, and we want to know about that beforehand and know it’s a risk and understand what we can about it.”
Colorado’s move to join the GOARN is also a prominent example of how the state has worked to develop public health capabilities that were once left to the federal government.
As federal health policy undergoes dramatic shifts during the administration of President Donald Trump and health Secretary Robert F. Kennedy Jr., Colorado has, for instance, joined a multistate alliance to collaborate on how to respond to disease outbreaks. The state has pushed back against changes in federal vaccine recommendations, instead endorsing guidance from prominent medical groups.
The theme is clear: While the federal agencies like the Centers for Disease Control and Prevention were once the bedrock of public health work across the country, states like Colorado now see that foundation as cracked.
“We used to think of CDC as the definitive source for health guidance,” Polis said. “Now we see them as a source for health guidance.”
“Lead time”
Dr. Rachel Herlihy, the deputy chief medical officer at the Colorado Department of Public Health and Environment, said participating in the GOARN will give Colorado valuable notice about germs that could head our way.
“Our awareness of those emerging infectious diseases in other countries really gives us the lead time that we need to make sure that we are prepared to respond in Colorado,” Herlihy said.
As an example of how this information might be used, look to an ebola outbreak in Uganda in 2022. Knowing about the outbreak prompted Colorado and other states to monitor travellers who lived in or had flown through Uganda to be sure they didn’t develop signs of the disease in the United States.
Herlihy said knowing about diseases in other parts of the world might prompt CDPHE to build up its testing capabilities for that disease, as in the case of mpox or bird flu. The state could potentially engage its wastewater monitoring system to look for traces of the disease germs.
How much can Colorado do on its own?
Colorado is not alone in seeking to join GOARN. Other states led by Democrats, including California, Illinois and New York, are also planning to join or have already joined.
Many of these same states have also either joined together or worked on their own to promote vaccine recommendations that may differ from what the federal government now proposes.
But how much can these states, working independently from federal institutions, actually accomplish? Does Colorado have the resources to do all this?
Polis downplayed the concern.
“We’re not generating our own information,” Polis said. “We’re looking at work from the American Academy of Pediatrics, from the World Health Organization. So it’s a little more coordination.”
Herlihy said that, in the past when providing public health guidance, CDPHE might have simply linked on its website to a page on the CDC’s website.
“Now it’s not always clear that the information on a particular CDC website is really based in the best science,” she said.
So, CDPHE might instead now link to, for instance, vaccine guidance from the American Academy of Pediatrics or disease information from the World Health Organization.
Polis acknowledged the extra responsibility, but said the goal is to provide reliable information, both to the public and to local public health officials.
“We want to make sure that we have the trust of the people of Colorado,” he said, “and we, in turn, have responsibility to deliver the best and most accurate scientific information to people to make their own decisions.”