Harmonisation and standardisation of wastewater-based epidemiology for public health protection and epidemic preparedness across the 4 nations

Enhancing Wastewater-Based Epidemiology for Public Health Security

Context: Wastewater-based epidemiology (WBE) has emerged as a vital tool for tracking disease outbreaks and predicting epidemics. WBE represents an effective way to undertake multi-pathogen surveillance, capturing the signal from many individuals, including those who are pre- and asymptomatic, in a single sample. Compared to conventional clinical testing, it is highly cost effective and relatively unbiased, simultaneously capturing all sectors of society irrespective of factors such as demographics and economic status.

Challenge: The project addresses the disjointed nature of current WBE initiatives that has resulted from poor integration of data linking to traditional clinical health surveillance. This lack of cohesion undermines effective disease surveillance and response efforts, especially concerning emerging epidemic and pandemic threats.

Aims and Objectives: Our interdisciplinary team, drawn from the university, government agency (with responsibilities for healthcare and environment), and industry sectors, comprises highly experienced researchers. Collectively, our expertise covers all areas of science, social sciences, public health, epidemiology, data analysis and modelling, relevant to WBE.

We aim to identify and prioritize critical research gaps and challenges associated with enhancing WBE for multi-pathogen surveillance. We already have a well-established track record of effective research collaboration over 4 years, which has already had an impact on the public health and policy across the UK.

Through workshops, reviews, and stakeholder engagement, we seek to advance WBE capabilities in sampling, bioinformatics, data integration, risk modelling, ethics, and communication. In this way, we aim to establish standardized practices for WBE surveillance across the UK's four nations, which will also provide an model internationally. In addition, we will seek to extend monitoring to establish a sound base for environment-based epidemiology (EBE), as a core component of a One Health surveillance system.

Key Activities:

Catalyst Event: A comprehensive kick-off event to identify opportunities and challenges in WBE-EBE surveillance.
Technology Mapping: Assessing current WBE approaches and identifying opportunities for improvement.
Data Integration Workshop: Engaging stakeholders to address data convergence and integration challenges.
Equity & Inclusion Workshop: Exploring ethical considerations and effective communication strategies.
Final Dissemination Event: Showcasing project outcomes and international perspectives to inform future research and policy.
Potential Applications and Benefits: Strengthening WBE capabilities will enhance public health surveillance and pandemic preparedness, enabling early pathogen detection and informed, evidence-based decision-making. Benefits extend across economic, social, health, security, and environmental dimensions, contributing to global health security.

Through these concerted efforts, we aim to maximize the societal benefit of WBE and EBE, demonstrating their pivotal role in national and global public health surveillance and pandemic preparedness.

Policy relevance: This project provides key evidence to support and underpin national policy, including Outcome 9 of the UK Biological Security Strategy, the UK Action Plan for Antimicrobial Resistance and implementation of the UK National Biosurveillance Network (see Letters of Support).