London School of Hygiene and Tropical Medicine, London, United Kingdom; University of New South Wales, Sydney, Australia; National Institute of Health Research Health Protection Research Unit in Sexually Transmitted Infections and Blood Borne Viruses, University College London, United Kingdom.
London School of Hygiene and Tropical Medicine, London, United Kingdom; University of New South Wales, Sydney, Australia.
Int J Drug Policy. 2021 Feb;88:102694. doi: 10.1016/j.drugpo.2020.102694. Epub 2020 Apr 1.
The field of public health is replete with mathematical models and numerical targets. In the case of disease eliminations, modelled projections and targets play a key role in evidencing elimination futures and in shaping actions in relation to these. Drawing on ideas within science and technology studies, we take hepatitis C elimination as a case for reflecting on how to think with mathematical models and numerical targets as 'performative actors' in evidence-making. We focus specifically on the emergence of 'treatment-as-prevention' as a means to trace the social and material effects that models and targets make, including beyond science. We also focus on how enumerations are made locally in their methods and events of production. We trace the work that models and targets do in relation to three analytical themes: governing; affecting; and enacting. This allows us to situate models and targets as technologies of governance in the constitution of health, which affect and are affected by their material relations, including in relation to matters-of-concern which extend beyond calculus. By emphasising models and targets as enactments, we draw attention to how these devices give life to new enumerated entities, which detach from their calculative origins and take flight in new ways. We make this analysis for two reasons: first, as a call to bring the social and enumeration sciences closer together to speculate on how we might think with models and targets differently and more carefully; and second, to encourage an approach to science which treats evidencing-making interventions, such as models and targets, as performative and political.
公共卫生领域充满了数学模型和数字目标。在疾病消除方面，模型预测和目标在证明消除未来和塑造与之相关的行动方面发挥着关键作用。借鉴科学技术研究的思想，我们以丙型肝炎消除为例，反思如何将数学模型和数字目标视为“表现性演员”，在证据制作中发挥作用。我们特别关注“治疗即预防”的出现，以追踪模型和目标所产生的社会和物质影响，包括超越科学的影响。我们还关注枚举在其方法和生产事件中是如何在本地进行的。我们追踪模型和目标在三个分析主题方面所做的工作：治理；影响；制定。这使我们能够将模型和目标定位为健康构成中的治理技术，这些模型和目标影响并受其物质关系的影响，包括与超出计算范围的关注事项有关的影响。通过强调模型和目标作为实施，我们提请注意这些设备如何赋予新的枚举实体生命，这些实体脱离了其计算起源，并以新的方式腾飞。我们进行此分析有两个原因：首先，呼吁将社会和枚举科学更紧密地结合起来，以推测我们如何以不同的方式更仔细地思考模型和目标；其次，鼓励一种对待证据制作干预措施（如模型和目标）的方法，将其视为表现性和政治性的。
