# Ethical Issues in AI-Enabled Disease Surveillance: Perspectives from Global Health
## 2 Disease Surveillance
The indicator-based component refers to structured or formal data collected through routine surveillance systems, such as the number or rates of cases based on standard case definitions, and the computation of indicators upon which abnormal disease patterns to investigate are detected [12]. Traditional indicator-based surveillance systems are based on the obligatory reporting of certain diagnosed diseases to a central health agency. Event-based disease surveillance systems use information on events impacting human health from Internet-based sources, including news aggregators and social media channels [21; 22; 23]. Event-based surveillance complements traditional approaches to public health surveillance and can provide early warning of emerging events, whereas there may be a lag in other forms of data aggregation due to delays in sample collection, laboratory confirmation, and country reporting, for example [24; 25]. The Medi + Board is an example of a dashboard framework which integrates public health surveillance data streams with zoonotic surveillance data [26], illustrating multiple geo-referenced and time series data. There are several established and active disease surveillance systems utilized to monitor disease trends, mainly using online news sources, across the globe. Among these are: the Global Public Health Intelligence Network (GPHIN), HealthMap, and ProMED [20; 21; 25; 27; 28]. A short description of these systems is outlined in Table 1.  
* GPHIN was established by the Public Health Agency of Canada in the late 1990s. * GPHIN is an automated surveillance tool, which collects non-structured, event-based, digital data from news feed aggregators and then reports to national and international health agencies, such as the WHO Global Outbreak Alert and Response System (GOARN). * In 2004, GPHIN detected severe acute respiratory syndrome (SARS) more than two months before the first publications by the WHO [29]. * URL: [[https://gphin.canada.ca/cepr/aboutgphin-rmispenbref.jsp?language=en_CA](https://gphin.canada.ca/cepr/aboutgphin-rmispenbref.jsp?language=en_CA)]([https://gphin.canada.ca/cepr/aboutgphin-rmispenbref.jsp?language=en_CA](https://gphin.canada.ca/cepr/aboutgphin-rmispenbref.jsp?language=en_CA)) (accessed on 1 November 2021)  
* HealthMap was established in 2006. * HealthMap uses online informal sources, such as ProMed and official-validated outbreak RSS feeds, for disease outbreak monitoring and real-time surveillance of emerging public health threats. * HealthMap also brings together disparate data sources, including online news aggregators, eyewitness reports, expert-curated discussions, and validated official reports. * The freely available website 'healthmap.org' and mobile app 'Outbreaks Near Me' deliver real-time intelligence on a broad range of emerging infectious diseases. * URL: [[https://healthmap.org/en/](https://healthmap.org/en/)]([https://healthmap.org/en/](https://healthmap.org/en/)) (accessed on 1 November 2021)  
* ProMED is a program of the International Society for Infectious Diseases (ISID). * ProMED was launched in 1994 as an internet service to identify unusual health events related to emerging and re-emerging infectious diseases and toxins affecting humans, animals, and plants. * ProMED is one of the largest publicly accessible surveillance systems conducting global reporting of infectious disease outbreaks. * URL: [[https://promedmail.org/](https://promedmail.org/)]([https://promedmail.org/](https://promedmail.org/)) (accessed on 1 November 2021)