A Life Surveilled
by: A Part of the Cluster
It is us now
soon it will be you, and then the world entire.
If my body is no longer mine,
if the code that shapes me is seized, observed, controlled
I vanish.
Not shadow, not echo, not life
nothing.
A hollow absence,
a void where self once clung,
a cog grinding without purpose,
a life drained of meaning,
a silence that swallows even the memory of my name.
Molecular HIV surveillance renders intimate biology legible to power, translating private viral histories into instruments of population control. The body is no longer sovereign; it is subsumed into circuits of governance, where consent is irrelevant and unfreedom is embedded in the very architecture of knowledge. By extracting genetic sequences from within the body, molecular HIV surveillance makes the intimate biology of infection- sex, sharing syringes, tattooing, breastfeeding, giving birth (the expressions of love, art, life itself )- legible to the state. The genome becomes a document of governance, a means through which the state inscribes its authority directly into the flesh, disciplining life at its most microscopic level. Genetic surveillance renders past intimacies and potential futures into data, making the undecidable into an instrument of certainty, while effacing the lives that gave rise to it.
This is more than a critique of Molecular HIV Surveillance (MHS) and Cluster Detection Response (CDR), it is warning and call to action to organize against dystopia. This system cannot be reformed. It must be abolished. We must resist its expansion and dismantle the technologies of governance that profiles, punishes, and criminalizes our most intimate interactions (Ferguson, 2024) article .
Ending the Epidemic funding functioned as a Trojan horse, marketed as a pathway to care and equity while quietly embedding MHS and CDR instrumentation into the existing surveillance and medical monitoring programs at state and location health departments, extending more state control over people living with HIV (PLHIV). Ending the HIV Epidemic (EHE) funding co-opted agencies for the rollout of genomic surveillance and sequencing technologies without meaningful involvement from community leaders (MIPA and the Denver Principles, 1983)^1 who can tell you what is actually going on in their neighborhoods, and what is needed to stop transmission. Just like the colonial mentality^2 that had access to the vast resources of an Empire where the Sun never set, but was unable to see the patterns of causation and consequences the source of the African AIDS Epidemic 60 years before the West acknowledged the virus. The public health surveillance state—always a hybrid of government (Belgium/US) and private enterprise (King Leopold's Company/Belloite)—sees only a means to an end. It advances its agenda regardless of pushback from the very communities it claims to serve; and any intercession by government is seen as a threat to the stability of the markets.
The state and Capital work together, affirm the other, and reinforce their authority over their respective principalities. Like Palantir, for example, the corporation that is literally named after the Seeing Stones in the Lord of the Rings series has unlimited resources to build computational and analytic systems that far exceed what is used by state health departments. So they bid on capacity building contracts for informatics, and biosecurity; and sell government agencies on technological novelties, like AI and predictive modeling; all while accumulating oceans of information from these sharing projects. Part of their work is building integrative data systems, so one source and communication with another, creating a profile based on unique identifiers. That isn't what the contract says the work is for, but what they built is capable of doing exactly that. And, who's to stop them from using that information in whatever way they want? It's theirs once it becomes part of the public-private partnership- (this is public information , if you want records just comment and ask). This should have been a red flag for program and procurement leadership, because these companies have no allegiance to the public and we have no legal way to demand oversight or transparency from their work. Without mass mobilizations and mutually beneficial support systems, the dawn of state corporatism and the christian dominionism will shine a light on the truth everywhere but it will be too late...
The Dichotomy Isn't Fundamental
Corporations like Palantir are building the infrastructure to support a new order for the social life of things- a world where everything is reified and managed according to their commodity form; and they're doing it in plane sight. These folks see the lines between private/public, state/company, religion/civic life , and so on, fading into the shadow of history; and they are prepared for the dawn of anew system.
What are we doing to resist?
Palantir works in three areas: (1) public health and biosecurity, (2) policing and immigration enforcement, and (3) corporate surveillance and risk analysis. Their entire framework of operations is based on surveillance and monitoring, collecting and centralizing data, and optimizing carcerality for the state. Palantir essentially turns data into weapons of governance and control, enabling predictive policing, deportations, and expanded surveillance infrastructures that disproportionately target minoritized communities and groups.
Why would anyone who is committed to public service and the optimization of individual and community health, think it is a good idea to let Palantir, or Deloitte, or Booze Allen Hamilton, etc., access the most sensitive datasets the epidemiological world has for its disposal?
In a previous post, I talked about the process of compartmentalization of knowledge in the division of labor and power structure at the state health department. By isolating tasks, workers are prevented from grasping the whole picture; and thus are shielded from accountability- should the chickens ever come home to roost. There isn't any one person to blame, just ideas and the system that reproduces them.
My unofficial investigative work as an intern in the Department of Epidemiology at the state health department led me to a series of contracts, current and historical, with Deloitte- another private entity with state-like operational control. They work with government to better implement and build capacity around new technology. They were offered contract in 2019, when MHS/CDR became the 4th Pillar of Ending the Epidemic. Note: To date the U.S. has invested $2.4 billion into the EHE program, with the 60% increase in funding as soon as CDR implementation was a mandate. Deloitte's other areas of work include: surveillance and data management outsourcing platforms, border enforcement, disease tracking, security and border enforcement; and this includes running critical infrastructure for agencies like the CDC, HHS, and the military. The contract I saw, which is public information if requested, paid Deloitte to build and manage platforms the technological platforms for epidemiologic response, contract tracing, and data integration (such as the system allowing Data to Care, Partner Services, and other care-marker databases to communicate). Deloitte is a shadow government, embedding private, corporate control into public infrastrures under the guise of efficiency, while profiting from surveillance and crises management (or epidemic response).
Here we are back Africa again, as private interests with the predictive capabilities to monitor the spread of disease, harvest enormous datasets, and operationalize advanced surveillance systems at scale; are authorized by the state with no ethical obligations or commitments to the communities from whom this data is collected and will share its effects. In fact, the state rewards this amorality as a function of the capitalist political economy. By supporting privacy and autonomy for corporations- instead of people- the laws and policies that are protecting intellectual property and trade secrets, intellectual property and free enterprise.
What of my privacy? Is my blood not my property? Why am I not afforded the same freedom?
Intellectual property protects creations of the mind, including data- which in the case of MHS, is a presentation of the material (blood). The ideas/data informing MHS and CDR are from actual material- genetic material, from blood, taken out of the body; and there aren't protections for that. In capitalist systems, we don't "own" out body in a property sense. Once tissue leaves the body, like blood samples, you lose rights over it (Moore v. Regents of the University of California (1990). Genetic information sequenced and turned into data is definitely more definitive of property than anything else I can imagine; but that is not how it is imagined by the logicians engineering this system. It doesn't seem the body is afforded many rights or protections, that are not related to its productivity, or labor power. The Marxist take on this is just a valid as the bioethical and Foucauldian perspectives in academia, and the abolitional frameworks used by international movements like Positive Women's Network, HIV Justice Network, SERO Project and others.
The corporeality of information collected and shared across the surveillance and data analytics markets originates from the bodies of those living with HIV, without our consent; and we have little to no knowledge of how it will be used, reused, and shared with governments and corporations in the global political economy. The State gives us only the lip service and the simulacra of assurance, without provisioning a single concrete policy to support a change in the structure. We cannot capitulate to biopower and comply with agenda setting at the imperial core. Examples of corporate involvement with surveillance systems are: Deloitte, Booze Allen Hamilton, Google Health, Oracle Health, and of my favorite: Palantir. Palantir, like the its peers, consults for governments and hospital surveillance systems. By biding on contracts too large for most local data analytics companies or academic institutions to manage, they are given accessible to data by the state health departments. They have no loyalty to the institutions that pay them, or the people these institutions are designed to serve. They are beholden to their shareholders. I will expand on this in Series V.
I Chose Palantir to make a point:
Like it’s namesake, the Palantir (seeing stones) in Tolkien’s Lord of the Rings is not inherently evil, but they can be used to manipulate and corrupt those who use them. Their power to reveal distant events and locations is seductive, but information presented can be incomplete, distorted, or used to deceive.
I think this conceptual metaphor is helpful because we haven’t built the language to describe what is happening and therefore we cannot imagine what effects it will have. One thing is certain, it has to be abolished and replaced with something grounded in community, transparency, and the principles of consensus process
Dystopia grows in plain sight but remains hidden because we cannot describe it (esoteric knowledge); we feel free (or protected) because we lack the language to articulate our own unfreedom (Zizek). With only a few of us organizing against the systems of powers orchestrating MHS and CDR, the threat becomes greater as more data is used to reach singularity in innovation. And lastly, why would Palantir name itself after the seeing-stones, who corrupted even the wisest and well-meaning of Middle Earth.
Concealed within his fortress, the lord of Mordor sees all. His gaze pierces cloud, shadow, earth, and flesh… (Saruman in Lord of the Rings using the Palantir, which means " far-seer". - this reflects how tyranny strips away privacy, under his eye, no secret or intimate interaction is safe, weaknesses are laid bare to the power and will of the one wielding the great eye. )
Technologies of Governance
We have to first understand the system before we can dismantle it.
State health departments claim it has strict protocols that limit data use to public health purposes only; but how do they define "public health" and how can we trust a system that is run by political appointment- especially now with fascising rising. The most powerful surveillance tool in the world has been built and implemented in every local and state agency sending real-time data to the imperial core, and I'm supposed to believe that protocols written by "Diane" are going to protect me? Absolutely not.
Potential
The combination of genetic, clinical, and operational data (records, geolocation, demographics, etc) can be used to identify exactly who you are, what sequence of HIV you have (even if you don't know you are positive yet), and with whom you've exchanged fluids containing the virus, be it through syringe use or sex, giving birth, or breastfeeding. If I can be done, it will be done. If not by the state, then by the corporation whose unchecked power has no recourse. One issue advocates warn us about is the potential use of MHS data in determining directionality, or knowing who infected whom. By itself, the data cannot do that; but when enhanced by other data types, inferences can be made: time-stamped clinical data (viral load, CD4 counts, diagnosis dates, ART initiation, all of which is monitored and recorded in the Data to Care system). Detailed phylogenetic analysis and full genome sequencing; epi and behavioral data; and partner notification.
Detailed Phylogenetic Analysis
- Full-genome sequencing (rather than partial pol genes used in MHS) allows better resolution of evolutionary direction.
- Time-scaled phylogenies and Bayesian methods (like BEAST) can be used to infer likely transmission paths and timing
Epidemiological/Behavioral Data
- Sexual or needle-sharing networks
- Partner services/contact tracingSelf-reported or clinically verified exposure histories
- Partner Notification and Cohort Studies
In controlled settings (e.g., couples-based studies), combining MHS with clinical timelines and relationship data can improve inference.
es.
If we authorize the state to expand these practices unchecked, they will do so. Consent, transparency, and accountability are already absent. Molecular HIV surveillance may serve prevention goals, but it also exemplifies the rise of a medical Leviathan, where health departments mirror the authoritarian tendencies of defense, policing, and security apparatuses. For those who know the history of dictatorship and fascism, the signs are clear. What was once a movement for liberation is now threatened by an expanding surveillance state that claims to save us even as it watches, monitors, and disciplines our lives.
Notes and Supplemental Documents
1. The Denver Principles
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