Ghana Health Service and partners advance wastewater surveillance to strengthen early disease detection
Story by: Regina Bless
The Ghana Health Service (GHS), in partnership with the Gates Foundation, the Noguchi Memorial Institute for Medical Research (NMIMR), the Kwame Nkrumah University of Science and Technology (KNUST) and other stakeholders, is taking steps to strengthen early disease detection through the validation and finalisation of Wastewater Environmental Surveillance (WES) guidelines.
The initiative aims to harness information obtained from wastewater to identify disease-causing pathogens circulating within communities, providing an additional early-warning mechanism to support public health decision-making, disease monitoring and outbreak preparedness.
The effort is expected to complement existing disease surveillance systems by helping health authorities identify potential public health threats before they become more widespread.
Stakeholders Review Wastewater Surveillance Guidelines
The stakeholder meeting brought together public health professionals, laboratory experts, researchers and disease surveillance officers to review the draft WES guidelines and establish a practical framework for integrating wastewater surveillance into Ghana’s Integrated Disease Surveillance and Response (IDSR) system.
Addressing participants on behalf of the Director-General and the Director of Public Health, Dr Dennis Odai Laryea, Deputy Director for Disease Surveillance, highlighted the importance of generating evidence through the initiative and strengthening collaboration among stakeholders.
He emphasised the need for a coordinated data management system to ensure that information from different sources is harmonised, properly analysed and translated into timely public health interventions.
The discussions underscored the importance of effective coordination among institutions responsible for disease surveillance, laboratory testing and public health response to ensure that findings from wastewater monitoring contribute meaningfully to national health planning.
How Wastewater Surveillance Supports Disease Detection
In a presentation on the overview of wastewater surveillance, Dr Azumah Abdul-Tawab explained that the approach involves collecting and testing wastewater samples to identify pathogens circulating within a community.
He noted that the method can help detect infections that might otherwise go unnoticed through routine clinical surveillance, particularly when infected individuals experience mild symptoms or show no symptoms at all.
Wastewater surveillance therefore provides an additional source of information on disease transmission patterns and can potentially identify emerging threats before they become apparent through conventional health reporting systems.
By monitoring pathogens in wastewater, public health authorities can gain broader insights into community-level disease activity and use the findings to guide further investigations, targeted testing and appropriate response measures.
Ghana Builds on Previous Environmental Surveillance Experience
Ghana has already demonstrated the value of environmental surveillance through the detection of circulating vaccine-derived poliovirus in 2019, 2020 and 2024.
These experiences provide a foundation for expanding wastewater surveillance beyond polio to include other pathogens of public health importance.
The proposed expansion is expected to strengthen the country’s ability to monitor infectious diseases, identify emerging threats and improve preparedness for potential outbreaks.
However, effective implementation will depend on reliable sampling procedures, laboratory capacity, accurate data interpretation and timely communication of findings to the relevant public health authorities.
Technical Review Focuses on Implementation
As part of the validation exercise, participants worked in groups to review key sections of the draft guidelines, including governance and coordination, priority pathogens, sampling methods, data management, reporting, monitoring and evaluation.
Group presentations and subsequent discussions helped identify gaps, clarify technical issues and propose amendments aimed at improving the accuracy, relevance and practical application of the guidelines.
Participants also highlighted the need for clear information-sharing pathways, stronger laboratory input and appropriate data-access platforms to ensure that authorised users can obtain the information needed to support timely decision-making.
These measures are considered important for establishing a coordinated surveillance framework in which data collected from different locations and institutions can be effectively consolidated and used to inform public health action.
Towards a Sustainable Wastewater Surveillance System
The validation and finalisation of the WES guidelines mark an important step towards establishing a more coordinated and sustainable wastewater surveillance system in Ghana.
Through continued collaboration among the Ghana Health Service, the Gates Foundation, NMIMR, KNUST and other stakeholders, the initiative seeks to strengthen early warning mechanisms, improve disease detection and enhance the country’s capacity to prepare for and respond to public health threats.
Once effectively integrated into the national disease surveillance framework, wastewater monitoring could provide health authorities with an additional tool for identifying emerging infections, tracking community-level transmission and guiding evidence-based interventions.
The initiative reflects a growing emphasis on combining laboratory science, environmental monitoring and conventional disease surveillance to support a more proactive approach to protecting public health in Ghana.