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

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.