Targeting therapies: Analysing the social and normative dimensions of 'targeted' approaches to biomedicine and public health.

Today, much in biomedicine and public health seems to involve the 'targeting' of therapies. By this, we mean that multiple forms of biomedical and public health praxis are aimed at discovering and delivering increasingly specific therapeutic modalities to individuals and populations. This includes varieties of medicine that have variously been termed 'personalised', 'precise', or 'stratified'. It also entails public health approaches that purposely or otherwise eschew such characterisations, but which nevertheless involve and propel congruent logics. The praxis of targeting by its very nature of course impacts therapies - including what the 'the therapeutic' per se might be taken to be. Importantly, it also actively shapes what diseases are or become, how knowledge about them is produced, and who is (not) able to access (what kinds of) care. Targeted therapies are thus not simply more precise medical or public health tools: they are sociotechnical interventions which simultaneously reconfigure markets, access, normativities, patient subjectivities, and disease ontologies. Metaphors, idioms, and imagery associated with targeting permeate many national and transnational healthcare and innovation ecosystems. The ubiquity and import of targeted therapies demand wider social scientific scrutiny that must ultimately cut across case studies and contexts.