Publication: Accessible ethics and legal advice for wastewater surveillance: The WWS ethics adviser app (PLOS Water, 2026)

Wastewater surveillance (WWS) is increasingly recognised as a valuable complement to national outbreak detection strategies. The communities from which wastewater is sourced should be the primary beneficiaries of these surveillance initiatives. To protect their interests, robust governance and ethical oversight are essential, helping to prevent harm and promote equitable practices that meet legal requirements and ensure appropriate use of surveillance data. As such, WWS policymakers and researchers can face challenges navigating the ethical and legal complexities of ensuring the compliant and responsible use of WWS samples and data.

In a collaboration led by PHA4GE (the Public Health Alliance for Genomic Epidemiology), ADBEx (the African Data and Biospecimen Exchange), and PDN (the Pathogen Data Network), with collaborators from SANBI (South African National Bioinformatics Institute) at the University of the Western Cape, University of Zaragoza, Medical University of South Carolina, and Asia PGI (Asia Pathogen Genomics Initiative) at the Duke-NUS Centre for Outbreak Preparedness, the group developed and designed an online interactive tool to guide users on context-specific ethical, legal, and governance considerations for WWS activities. The tool offers tailored advice for WWS practitioners, oversight committees, and responsible parties, in order to support equitable, ethical, and legal WWS practices across diverse settings and use cases. Introduced in a publication in PLOS Water (2026), the tool is freely accessible at: https://wastewater-surveillance-ethics.streamlit.app/.

• The WWS Ethics Adviser app prompts users to select the WWS molecular entities and subtypes of interest, and their origins.
• Users are then guided through ethical and governance alerts relevant to their scenario, outputting tailored considerations and recommendations.
• The back-end matrix was created through an iterative, consultative process with experts from the PHA4GE Consortium and specialists in WWS, pathogen genomics, data management, research ethics, equity, law, and data governance.
• A wide range of publications and resources were referenced, including international and national legislation (e.g., South Africa’s Protection of Personal Information Act, UK's General Data Protection Regulation, The Nagoya Protocol) and ethics guidelines (e.g., WHO Guidelines on Ethical Issues in Public Health Surveillance).
• Users can provide voluntary feedback on usability and content via a link on the home page, enabling continuous monitoring and improvement.