Making Waves: A justice-centred framework for wastewater-based public health surveillance

• Ethical dimensions of wastewater-based surveillance programs remain unresolved • International, interdisciplinary, and multisectoral teams can ensure just outcomes • Commons issues of community, transparency, and geography are identified • Across contexts, a common framework rather than universal regulations are needed • Fraser's theory of justice evaluates maldistribution, misrecognition, and exclusion Since 2020 wastewater-based surveillance has quickly been established as an effective and cost-efficient tool for monitoring global public health. In this Making Waves article, we argue that these programs must be grounded in principles of justice to achieve global water and health equity. Ethics initiatives to date have focused primarily on privacy, legality, and institutionalised research reviews, often, if not exclusively, in North America and Western Europe. We draw…