About

4 Nations: Aims and Objectives 

Our goal is to identify and prioritise the key research gaps and challenges in advancing wastewater-based epidemiology (WBE) for multi-pathogen surveillance. Building on over five years of successful collaboration, our team has already made a tangible impact on public health and policy across the UK.

Through workshops, reviews, and engagement with stakeholders, we are enhancing WBE capabilities in sampling, bioinformatics, data integration, risk modelling, ethics, and communication. By doing so, we aim to establish standardised national practices for WBE surveillance across the UK’s four nations, creating a model that can be adopted internationally. We also aim to expand monitoring to form the basis of environment-based epidemiology (EBE) as part of a One Health surveillance system that connects human, animal, and environmental health.

Why take this approach and what are its benefits? 

The emergence of pathogens such as SARS-CoV-2 (COVID-19), norovirus, and antimicrobial-resistant (AMR) organisms pose serious and ongoing public health challenges. These pathogens can spread through contaminated water and food, often originating from human sewage. Norovirus alone causes millions of illnesses each year, leading to significant healthcare costs and lost productivity. AMR represents an even greater long-term threat, with estimates suggesting a potential global economic impact of up to £100 trillion by 2050.

Wastewater-based and environment-based epidemiology (WBE and EBE) offer powerful, complementary tools to confront these threats. By detecting multiple pathogens in a single sample, WBE enables early identification of outbreaks and novel pathogens with pandemic potential. Integrating scientific, ethical, and technological innovations across the four nations ensures harmonised, standardised surveillance, reinforcing epidemic preparedness and supporting a resilient, One Health approach to protecting public health.

Strengthening WBE capabilities will improve surveillance, pandemic preparedness, and early pathogen detection, supporting timely, evidence-based decision-making. The benefits extend across health, economic, social, security, and environmental domains, contributing to stronger national resilience and global health security.