TY - JOUR
T1 - Opportunities and limits of wastewater-based epidemiology for tracking global health and attainment of UN sustainable development goals
AU - Adhikari, Sangeet
AU - Halden, Rolf U.
N1 - Funding Information:
This study was made possible in part by the J.M. Kaplan Fund's OneWaterOneHealth nonprofit project award 30009070 to the Arizona State University.
Funding Information:
The authors would like to acknowledge Dr. Rahul Kumar, Dr. Erin M. Driver, and Dr. Kerry Hamilton for their initial feedback on the manuscript. We also thank our sponsors who made possible this work and the ongoing screening of global wastewater samples in our laboratories at the ASU Biodesign Institute in Tempe, AZ. This study was made possible in part by the J.M. Kaplan Fund's OneWaterOneHealth nonprofit project award 30009070 to the Arizona State University.
Publisher Copyright:
© 2022 The Authors
PY - 2022/5
Y1 - 2022/5
N2 - Wastewater-based epidemiology (WBE) emerged as a powerful, actionable health management tool during the COVID-19 pandemic. Hypothesizing future uses, we explored its potential for real-time, tracking of progress in attaining United Nations Sustainable Development Goals (SDGs) globally as a non-expensive method using existing infrastructure. We inventoried (i) literature-documented sewerage infrastructure, (ii) demographics of populations served, and (iii) WBE markers informative of 9 SDGs. Among the 17 different sustainable development goals listed by the UN 2030 agenda, more than half of these may be monitored by using WBE monitoring at centralized treatment infrastructure as tabulated in this study. Driven mainly by COVID-19, WBE currently is practiced in at least 55 countries, reaching about 300 million people. Expansion of WBE to 109,000 + treatment plants inventoried in 129 countries would increase global coverage 9-fold to 34.7% or 2.7 billion, leaving out 5 billion people not served by centralized sewerage systems. Associations between population demographics and present-day infrastructure are explored, and geospatial regions particularly vulnerable to infectious disease outbreaks are identified. The results suggest that difference in the differential outcomes in well-being is an outcome of the sanitation infrastructure inequalities and lack of sanitation infrastructure creates doubly disadvantaged populations at risk of poor hygiene and cut off from the early-warning benefits of conventional WBE. This is the first study to explore the feasibility and potential barriers to the use of WBE for tracking the attainment of SDGs globally with at least 9 out of 17 SDGs.
AB - Wastewater-based epidemiology (WBE) emerged as a powerful, actionable health management tool during the COVID-19 pandemic. Hypothesizing future uses, we explored its potential for real-time, tracking of progress in attaining United Nations Sustainable Development Goals (SDGs) globally as a non-expensive method using existing infrastructure. We inventoried (i) literature-documented sewerage infrastructure, (ii) demographics of populations served, and (iii) WBE markers informative of 9 SDGs. Among the 17 different sustainable development goals listed by the UN 2030 agenda, more than half of these may be monitored by using WBE monitoring at centralized treatment infrastructure as tabulated in this study. Driven mainly by COVID-19, WBE currently is practiced in at least 55 countries, reaching about 300 million people. Expansion of WBE to 109,000 + treatment plants inventoried in 129 countries would increase global coverage 9-fold to 34.7% or 2.7 billion, leaving out 5 billion people not served by centralized sewerage systems. Associations between population demographics and present-day infrastructure are explored, and geospatial regions particularly vulnerable to infectious disease outbreaks are identified. The results suggest that difference in the differential outcomes in well-being is an outcome of the sanitation infrastructure inequalities and lack of sanitation infrastructure creates doubly disadvantaged populations at risk of poor hygiene and cut off from the early-warning benefits of conventional WBE. This is the first study to explore the feasibility and potential barriers to the use of WBE for tracking the attainment of SDGs globally with at least 9 out of 17 SDGs.
KW - Biomarkers
KW - Centralized wastewater treatment plants
KW - Global health
KW - Sustainable development goals
KW - WBE
KW - Wastewater infrastructure
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U2 - 10.1016/j.envint.2022.107217
DO - 10.1016/j.envint.2022.107217
M3 - Review article
C2 - 35395576
AN - SCOPUS:85128856895
SN - 0160-4120
VL - 163
JO - Environment international
JF - Environment international
M1 - 107217
ER -