Problematising the emergence of outbreak science in the governance of global health: making time for slow dis-ease

ABSTRACT

There is growing investment in the development of new methods, networks, and infrastructures of knowledge coordination to prepare for disease threats to come. ‘Outbreak science’ is an emerging field that proposes to improve epidemic preparedness and precautionary response. But what are the effects of framing and governing ‘outbreaks’ in this anticipatory mode? What ways of knowing and doing preparedness and response does outbreak science open up and foreclose through its promise of fast, actionable information in situations of uncertainty? We consider how ‘outbreak’ is made governable through its evidencing, with profound, and unevenly distributed, social and material repercussions. We focus on one problematisation intrinsic to outbreak science, that is, the need for speed. Drawing on work in Science and Technology Studies (STS) on pollutants and the slow burn of environmental harms, we argue that constituting ‘outbreak’ as a problem to be managed with immediacy and speed obscures the long-enduring temporalities and complex ecological relations of disease. We suggest ‘slow dis-ease’ in conjunction with ‘perpetual care’ as alternative modes of problematising outbreak. There is a practical difference made possible by making time for slow dis-ease, a time that is currently lost by the rapid, anticipation and short-term event focus of outbreak science.

KEYWORDS:

• Outbreak science
• science and technology studies
• evidence
• temporality
• perpetual care

Acknowledgements

We are grateful for support from the UNSW SHARP (Tim Rhodes) and Scientia (Kari Lancaster) schemes. Kari Lancaster is supported by the Australian Research Council DECRA Fellowship (DE230100642).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Notes

1. Examples of recent investments and initiatives in outbreak science globally include: the Johns Hopkins Center for Public Health Preparedness; the MRC Centre for Global Infectious Disease Analysis; the London School of Hygiene and Tropical Medicine Centre for Epidemic Preparedness and Response; the University of Oxford Pandemic Sciences Institute; the National Institute for Health Research Health Protection Research Unit in Emergency Preparedness and Response; the Institute of Development Studies Pandemic Preparedness program; Rutgers Center for COVID-19 Response and Pandemic Preparedness; the Duke-NUS Centre for Outbreak Preparedness; the Task force for Global Health; the Global Research Collaboration for Infectious Disease Preparedness; the Global Task Force on Pandemic Response; the Early Warning and Response System of the European Union (European Centre Disease Prevention & Control); Outbreak Response Division of Foodborne, Waterborne, and Environmental Diseases, and the Emergency Preparedness and Response division, Centers for Disease Control and Prevention; the World Bank’s the Regional Disease Surveillance Systems Enhancement Program; the World Health Organization’s Health Emergencies Programme; the Coalition for Epidemic Preparedness Innovations; the UK National COVID-19 Wastewater Epidemiology Surveillance Programme; the UK NHS Environmental Monitoring for Health Protection wastewater surveillance programme; the SCORE-NORMAN SARS-CoV-2 in sewage database.

Additional information

Funding

This work is funded by the Australian Research Council (DE230100642).