Catching the flu: Syndromic surveillance, algorithmic governmentality and global health security

How do algorithms shape the imaginary and practice of security? Does their proliferation point to a shift in the political rationality of security? If so, what is the nature and extent of that shift? This article explores these questions in relation to global health security. Prompted by an epidemic of new infectious disease outbreaks – from HIV, SARS and pandemic flu, through to MERS and Ebola – many governments are making health security an integral part of their national security strategies. Algorithms are central to these developments because they underpin a number of nextgeneration syndromic surveillance systems now routinely used by governments and international organizations to rapidly detect new outbreaks globally. This article traces the origins, design and evolution of three such internet-based surveillance systems: 1) the Program for Monitoring Emerging Diseases, 2) the Global Public Health Intelligence Network, and 3) HealthMap. The article shows how the successive introduction of those three syndromic surveillance systems has propelled algorithmic technologies into the heart of global outbreak detection. This growing recourse to algorithms for the purposes of strengthening global health security, the article argues, signals a significant shift in the underlying problem, nature, and role of knowledge in contemporary security practices.