Wastewater surveillance for early pathogen detection in Asia

Wastewater surveillance for early pathogen detection in Asia

International Journal of Environmental Health Research

10.1080/09603123.2025.2544736

https://doi.org/10.1080/09603123.2025.2544736

Junxiong Pang, Judith Chui Ching Wong, Suci Melati Wulandari, Martin Tay, Erik Albert Karlsson, Vicka Oktaria, Imran Nisar, Munirul Alam, Indah Kartika Murni, Afreenish Amir, Farah Ishtiaq, Zhang Tong, Masaaki Kitajima, Monica Nolan, Sandy Tze-Minn Mak, Sebastian Maurer-Stroh, Gavin James Smith, Ruklanthi de Alwis, Yann Felix Boucher, Lee Ching Ng, Paul Michael Pronyk

19 August 2025

Pang, J., Wong, J. C. C., Wulandari, S. M., Tay, M., Karlsson, E. A., Oktaria, V., Nisar, I., Alam, M., Murni, I. K., Amir, A., Ishtiaq, F., Tong, Z., Kitajima, M., Nolan, M., Mak, S. T.-M., Maurer-Stroh, S., Smith, G. J., de Alwis, R., Boucher, Y. F., et al. (2025). Wastewater surveillance for early pathogen detection in Asia. International Journal of Environmental Health Research, 1–10. https://doi.org/10.1080/09603123.2025.2544736

Wastewater surveillance (WS) has emerged as an important population-based surveillance tool for early pathogen detection to inform timely public health action. Despite global guidance to initiate WS programming in Asia, the priorities and needs in Asia remain poorly understood. To address this gap, we conducted a cross-sectional assessment of WS efforts in Asia. An institutional survey recorded 89 separate projects among 45 institutions in 19 countries in Asia. Financing for WS was equally split between domestic and external resources. Most projects were research-oriented, with one-fifth embedded within national surveillance systems. Influents from urban wastewater treatment plants were the most common sampling sources identified, with either monthly or weekly sampling frequencies. Most efforts were single-pathogen focused, with SARS-CoV-2, antimicrobial resistance (AMR) bacteria, enterovirus, influenza and poliovirus being the top five pathogens assessed. Despite challenges including limited funding and government support, there has been substantial recent progress on the adoption of WS across Asia. Opportunities to enhance sustainability and scale will depend upon efforts to document public health use cases, support national planning and budgeting, develop tailored protocols and regional guidance, and advance innovative multi-pathogen approaches that leverage innovations including pathogen genomics to advance cost-efficient WS systems for public health impact.

Attribution 4.0 International (CC BY 4.0)

This research/ project is supported by Bill and Melinda Gates Foundation

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.

https://oar.a-star.edu.sg/communities-collections/articles/23077

0960-3123
1369-1619

Bioinformatics Institute

https://doi.org/10.1080/09603123.2025.2544736