Accessible ethics and legal advice for wastewater surveillance: The WWS ethics adviser app

Wastewater surveillance (WWS) has a long history in infectious disease management, from the detection of Salmonella Paratyphi B in sewers by Moore in 1948, to its role in global poliovirus eradication and more recently the deployment of WWS to track SARS-CoV-2. Whilst current interest has focused on pathogen sequencing to monitor outbreaks, WWS encompasses a much broader molecular landscape that includes a wide array of chemical compounds, proteins and DNA from human, animal, plant and microbial organisms. This diversity creates novel opportunities for public health applications, environmental monitoring, biodiversity studies, forensic science and even commercial innovation. The communities from which wastewater is sourced should be the primary beneficiaries of surveillance efforts, but WWS also requires robust governance mechanisms and ethical oversight to prevent harm to communities, ensure equitable practices, fulfil legal obligations and ensure appropriate use of potentially sensitive or commercially valuable findings. End-users of WWS resources must navigate these complexities to ensure ethical and legal compliance and responsible use of WWS samples and data. To assist with this process, we developed the WWS Ethics Adviser, an online interactive tool designed to alert users to context-specific ethical, legal, and governance considerations in WWS activities. The app aims to synthesise the principles of guidelines, treaties and other complex frameworks and resources into concise and actionable information for end users. The content is created within a two-dimensional matrix that categorises molecular entities and their origin against corresponding ethical, legal and governance elements. 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, and can be found at: https://wastewater-surveillance-ethics.streamlit.app/ .