Post-COVID-19 pandemic perspectives on the need for wastewater surveillance of pathogenic microorganisms, antibiotics, and antimicrobial resistance in South Asia

After the out-break of the COVID-19 pandemic, antibiotics, antimicrobial determinants and human pathogens are of emerging concern since they can pose serious threat to human health. Given the high population density and threats of untreated wastewater, South Asian countries might face a potential health risk due to the antimicrobial resistance (AMR). Hence in this review, we are providing insights on how wastewater serves as a crucial conduit for the loading of pathogenic microorganisms, antibiotics and antimicrobial resistance genes (ARGs) in a given catchment. We recommend that countries lacking community-level data, particularly on AMR can use wastewater surveillance (WS) to predict the future waves of any epidemic/pandemic and understand the situation of AMR via environmental pathways. Moreover, WS can be used as a cost-effective technique to monitor the health condition even for marginal-income communities in developing countries lacking access to clean water, sanitation, and health facilities.