With colleagues from the University of Melbourne, Priyanka Pillai and Kristal Spreadborough, I’ll be presenting at the AusSTS workshop in Melbourne held on 24 and 25 June. Details of the workshop are available here: https://scienceandsocietynetwork.deakin.edu.au/call-for-applications-aussts-2021-situated-practice-a-multi-sited-workshop/
The paper is based on some recent work that I’ve been doing as part of an interdisciplinary team about HIV data and its uses in global health, looking at one manifestation - the “cascade of care” (a.k.a. and sometimes overlapping with what is called the continuum of care). I am hoping the workshop can offer an opportunity some emergent themes on governmentality through data in global health regimes, building on my completed book manuscript on the globalisation of concepts for gender and sexual diversity in Indonesia.
The title and abstract is below - if you are in Melbourne, I hope to see you at this fantastic workshop!
Title: Seeing like a cascade - global HIV data and public health governance in Indonesia
Keywords: data, public health, HIV, cascade, Indonesia
Abstract: The “cascade of care” is a widely used tool in measuring national and international progress towards HIV testing and treatment goals. Since 2014, these goals have been to achieve 90% of HIV+ people know their status, 90% of people who know their status on treatment, and 90% of people on treatment are virally suppressed. Thus, these targets serve as a catalyst to rapidly and as widely as possible roll out anti-retroviral treatment with the ultimate aim being to end AIDS in the near future. The “cascade” individualises “treatment” and “prevention,” and simplifies the complexities of accessing life-long treatment into a biomedical and pharmaceutical model. Yet a less widely acknowledged aspect of the “cascade” in international HIV programs is the fact that it is accompanied by and indeed necessitates the expansion of systems of collecting, storing and analysing data. We argue that the cascade is not only a method concerned with clinical treatment but has led to the prioritisation of data-driven models which draw “surveillance” (data about the state of the epidemic) together with “monitoring and evaluation” (data about programs). Focusing on SIHA, the Indonesian Ministry of Health Information System for HIV/AIDS developed in 2012, this paper analyses various visualisations of the “cascade” and the data infrastructures that underpin it. We use these visualisations to understand both flows of data in and between actors and the categories that they use in the process. In contextualising how national Indonesian data infrastructures “see like a cascade” we seek to clarify what public health governance does and for whom.
Authors:
Benjamin Hegarty is an interdisciplinary gender and sexuality studies scholar and McKenzie Fellow at the University of Melbourne.
Priyanka Pillai has a background in bioinformatics and computer science and works as an academic specialist at the University of Melbourne.
Kristal Spreadborough is a Research Data Specialist at the Melbourne Data Analytics Platform. Kristal’s research interests cut across the fields of data, digital and data ethics, music, psychology and semiotics.