Ethical Hotspots in Infectious Disease Surveillance for Global Health Security: Social Justice and Pandemic Preparedness

At the time of writing, the world remains in the grip of the COVID-19 pandemic. This, along with recent experiences of Ebola and Zika outbreaks, has led to calls for the development of better and more coordinated global strategies for effective pandemic preparedness, response, and prevention. Particular emphasis has been placed on the need for improved infectious disease surveillance and intelligence. Questions of social justice have been a prominent feature of public and academic debate during the pandemic. These have understandably tended to focus on interventions in pandemic response. This chapter argues that important questions of social justice also arise with respect to the impacts of pandemic preparedness and prevention and that infectious disease surveillance is a particularly important example. Although the development and implementation of an effective system of infectious disease surveillance constitutes a vitally important global public good, many of the costs of making this a reality will be borne by those living in marginalized communities in Africa, Latin America, and South-East Asia. Many of the interventions required are likely to have significant negative impact upon the well-being of those who live in such hotspots. New forms of surveillance will mean that these populations will become highly observed, monitored, and intervened upon. Against this backdrop, the chapter identifies a number of new ethical challenges arising in infectious disease surveillance and argues that significant obligations are owed to those who live in these regions. The chapter argues that infectious disease hotspots are also ethical hotspots.