Written By: Glory Ayobami Ogunbodede
Imagine if the gutters and canals snaking through our cities were not just eyesores, but silent witnesses to our health. While we often look away from the murky waters of Lagos or the open drains in Kano, these “wastewaters” carry a chemical and biological diary of every community they pass through. This is the essence of Wastewater-Based Epidemiology (WBE), the science of testing sewage to track diseases before they reach hospitals. In our country, where seeing a doctor is often a luxury of last resort, our “waste” might be the most honest storyteller we have. But the question remains: Are we listening?
Nigeria is not entirely new to this. Long before COVID-19 made “surveillance” a household word, we were already using sewage to fight polio. Since 2011, environmental surveillance (ES) has been a critical tool in our public health arsenal. When the wild poliovirus was still a shadow over the nation, health workers weren’t just checking paralysed limbs; they were dipping bottles into drains in Borno, Sokoto, and Kano. This enabled officials to detect the virus circulating in a neighbourhood months before any child showed symptoms. It was proactive, not reactive. This success demonstrated that WBE works in the Nigerian context, but it also created a “polio silo,” in which the infrastructure exists for one disease while others slip through the cracks.
While Nigeria has used this tool as an “emergency” measure, other countries have turned it into a high-tech shield. In 2020, the U.S. Centres for Disease Control (CDC) established the National Wastewater Surveillance System (NWSS). What started as a COVID-19 tracker has evolved into a multi-disease dashboard. In states like Nevada and Arizona, wastewater data enabled health officials to deploy mobile vaccination clinics to specific neighbourhoods where Mpox incidence was rising long before clinics experienced a surge in patients. Today, the U.S. leverages this system to track everything from seasonal flu to the spread of “superbugs” across 1,500 sampling sites covering nearly half the population. The Netherlands was among the first to demonstrate that wastewater data could predict COVID-19 waves up to a week earlier than hospital data. This “lead time” is the holy grail of global health; it allows hospitals to stock up on oxygen and governments to adjust policies before the crisis hits its peak.
Now, wastewater surveillance is not just a “rich country” luxury; it is a global health equaliser. For the world to be safe from the next pandemic, we need “eyes” in every corner. Many diseases, like Hepatitis A or silent strains of Flu, spread through people who don’t feel sick enough to go to a clinic. Wastewater catches these “ghost” infections. Additionally, as flooding becomes more common in Nigeria, wastewater systems are increasingly contaminated. Real-time monitoring allows us to track waterborne outbreaks like Cholera as they happen, rather than weeks later.
But the question is, “If the science is so sound, why isn’t every state in Nigeria doing this?” The reality on the ground is complicated.
In the U.S., WBE is “easy” because most people are connected to a central sewage system. In Nigeria, we have a “decentralised” reality. Most households rely on septic tanks, soakaways, or open drains. When there is no central “pipe,” it is extremely difficult to obtain a representative sample of the entire population. Additionally, our drains aren’t just for human waste. They transport rainwater, industrial discharges, and large volumes of plastic. This “noise” makes the lab work incredibly difficult. Finding a tiny viral fragment in a soup of chemicals and silt requires high-end equipment and consistent electricity, two things that many of our local laboratories struggle to maintain.
Making the Shift: From Research to Reality
Nigeria is great at creating “blueprints.” We have the National Centre for Disease Control (NCDC) leading the charge. But to move wastewater surveillance from a research project to a life-saving tool, we need to get practical.
We don’t need the U.S. model to succeed. We can use “grab sampling” from open drains and develop “passive samplers” specifically designed for the Nigerian environment. Additionally, data from the Ministry of the Environment must be shared with the Ministry of Health. If a researcher finds high levels of antibiotic-resistant bacteria in a canal in Gombe, this should immediately trigger a public health campaign in that district.
In conclusion, wastewater surveillance in Nigeria is currently at a crossroads. We have the historical expertise from the polio era and the academic brilliance of our researchers. However, we are still constrained by a lack of infrastructure and a disconnect between data and action. If we want to move “Beyond the Buzz,” we must stop seeing our wastewater as merely a nuisance to be ignored. It is a biological early-warning system, a silent messenger that, if listened to, could save thousands of lives. It’s time we stopped looking away from the gutter and started looking at what it’s trying to tell us. Our collective health and the world’s depend on it.