Post-COVID-19 pandemic perspectives on the need for wastewater surveillance of pathogenic microorganisms, antibiotics, and antimicrobial resistance in South Asia

After the COVID-19 pandemic, antimicrobial determinants, and human pathogens are of deeper concern since they can pose a serious threat on public health. Given the high population density and threats of untreated wastewater, South Asian countries might face a potential health risk due to antimicrobial resistance (AMR). Hence, in this review, we are providing insights into how wastewater serves as a crucial conduit for loading pathogenic microorganisms, antibiotics, and antimicrobial resistance genes (ARGs) in a given catchment. We recommend that countries lacking community-level data, particularly on AMR, use wastewater surveillance (WS) to predict the future waves of any epidemic/pandemic and understand the situation of AMR via environmental pathways. Moreover, WS can be used as a cost-effective technique to monitor health conditions even for marginal-income communities in developing countries lacking access to clean water, sanitation, and health facilities.