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Abstract Details
How to Think With Models and Targets: Hepatitis C Elimination as a Numbering Performance
Int J Drug Policy. 2020 Mar 31;102694. doi: 10.1016/j.drugpo.2020.102694. Online ahead of print.
Tim Rhodes1, Kari Lancaster2
Author information
1London 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. Electronic address: tim.rhodes@lshtm.ac.uk.
2London School of Hygiene and Tropical Medicine, London, United Kingdom; University of New South Wales, Sydney, Australia.
Abstract
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.