Total Integration – reviving the Biomedical Platform as an analytical tool

This collaboratively written article develops and updates Keating and Cambrosio’s concept of the ‘biomedical platform’ to analyse its relevance in an era of globalised, data-intensive biomedicine. Since the turn of the 21st century, platforms—understood as socio-technical arrangements integrating materials, practices, standards, and regulatory forms—have become indispensable “workbenches” connecting multiple levels of contemporary bio-science, surveillance, and governance. The article demonstrates the urgent need for social scientific and historical perspectives to make sense of the proliferation, interdependency, and political economy of platforms across scales, from laboratory techniques to global health infrastructures. Through case studies of microbial typing, vaccine innovation, and epidemiological surveillance, the article details how platforms operate through interlayering and “plug-and-play” logics that standardize inputs and outputs while enabling rapid expansion into new domains. These dynamics have driven major advances, including high-throughput genomic surveillance, adaptable viral vector and mRNA vaccine platforms, and increasingly integrated data ecosystems for epidemic intelligence. At the same time, platforms generate new forms of power, exclusion, and inequality. Proprietary architectures, gatekeeping between competing systems, and the assetization of data and technologies concentrate control among a limited set of public-private actors, while marginalising resource-poor settings and alternative approaches. We argue that platform interdependency is now a defining feature of 21st-century biomedicine and global health, restructuring transnational knowledge production, labour, and governance. While platforms offer significant efficiencies, they also risk privileging standardization over contextual understanding and reinforcing global disparities. We call for renewed social scientific attention to platform ecosystems, their hegemonic tendencies, and emerging possibilities for more equitable and accountable forms of platform-based biomedicine.