Below are the footnotes that appear throughout the course: 

  1. Similar issues may arise in the context of quality assurance, health systems research, implementation research and operational research; this point could be raised during the discussion.

  2. See learning objective 3.2. It has even been claimed that informed consent is at odds with the goals of surveillance (Verity, Nicoll, 2002). If informed consent were required before identifiable reporting could be conducted, for example, it might be difficult (or impossible) to accurately estimate the incidence and/or prevalence of diseases. This, in turn, could lead to inadequate implementation of control measures, ultimately jeopardizing population health.

  3. This section is based on Selgelid (2014).

  4. We focus here on the distinction between surveillance and research proposed by the CDC, because (despite the concerns raised below) it is especially well developed and influential.

  5. Generalizability of knowledge might be a matter of degree rather than “either–or”.

  6. One possibility might be a distinction based on the activities involved rather than intentions or purposes, but this might likewise lead to paradoxical conclusions. Another possibility might be to give up the idea of drawing a sharp boundary between research and surveillance (and thus public health practice) by recognizing a possible continuous spectrum between the two; i.e., rather than asking whether an activity is research or surveillance, we might consider the degree to which it is one or the other, which might depend on the degree to which the aims include producing generalizable knowledge and/or reducing disease and improving health. These and other possible methods of distinguishing research from surveillance could be raised in discussion.

  7. These case studies were provided by Philippe Calain.

  8. As used here, “race” refers to a group of people connected by common descent or origin.

  9. “Ethnicity” here refers to the culture and/or collective identity shared by a group of people of common descent or origin.

  10. “First‑line” TB drugs are those used to treat ordinary strains of M. tuberculosis. “Second‑line” drugs are used to treat drug‑resistant strains.

  11. A somewhat analogous example that also raises ethical issues is proposed research on black African immigrants to the USA that includes the collection and storage of genetic information (Buseh et al., 2013). This could lead to information and products that could benefit humanity and future African communities, but there is concern that the benefits might not be shared with these communities.