Wastewater Surveillance for Disease Epidemiology

Abstract

Wastewater-based epidemiological surveillance (WBE) showed the potential to become a pivotal public health tool for measuring community disease burden during the COVID-19 pandemic. Many countries used WBE as part of their national disease surveillance to inform on the optimal deployment of public health measures. In India, civil society groups, research institutions, and private companies across various urban areas also demonstrated the utility of WBE in assessing community burden. While the European Union has recently begun to craft policies for the integration of WBE into a global surveillance network, many countries (including India) do not have a national policy to enable such integration. This paper argues for a national wastewater surveillance system for India, covering community-level assessment of various public health threats, along with integration of data from urban marginalised populations, to promote health equity and facilitate OneHealth-based thinking of disease emergence and spread. The paper outlines WBE efforts around the world, highlights its advantages as a cost-effective tool to supplement rather than supplant existing frameworks, and makes a case for its implementation in India, along with recommendations for next steps towards such implementation. The effective use of WBE should help India identify areas of emerging health threats, prepare for future infectious disease outbreaks, and allocate resources according to population requirements.