Digital disease surveillance and neocolonial governance of the global south

Abstract This letter discusses the ethical risk of neocolonial infrastructural capture in global disease surveillance. It shows how low- and middle-income countries (LMICs) often remain dependent on externally controlled analytic tools, data standards, and technological systems, concentrating epistemic authority in the Global North. Traditional ethical approaches, including privacy protections and equitable benefit sharing, fail to address these structural inequities. The letter calls for infrastructural justice, LMIC ownership of data infrastructures and local governance of algorithmic decision-making to prevent long-term power imbalances.