As climate change continues to reshape our environment, its impact on infectious diseases is becoming harder to ignore. Changing temperatures and shifting ecosystems are expanding the range of disease-carrying vectors and creating new opportunities for pathogens to spread.
This is especially concerning at the wildlife-human interface, where climate pressures and human encroachment blur the boundaries between people and animals, increasing the risk of zoonotic spillover.
One of the biggest challenges in tackling this problem is surveillance. Most infectious disease tracking relies on diagnosed cases, meaning people who don’t or can’t access healthcare are left out of the data. And that’s a lot of people—especially in remote areas where emerging infections often surface first. To help close this gap, our team is working to establish wastewater-based epidemiology (WBE) as a tool for tracking infectious diseases in the Peruvian Amazon.
Laying the Groundwork in Iquitos
In early February, Ximena Tovar and I traveled to Iquitos, Peru—one of three planned pilot sites—to get this effort off the ground. Working closely with the regional health department and local hospital labs, we’re mapping out how sewage moves through the city and into the Amazon River. This will help us pinpoint which communities contribute to each wastewater site, allowing us to track disease trends in specific areas.
At the same time, we’re building capacity in Peru by working with university labs in Lima to strengthen sequencing and metagenomics expertise, while training researchers in Iquitos to run these methods independently.
The first phase of our project focuses on 4–6 urban sites in Iquitos, where we plan to collect wastewater samples and test them in the lab. Using PCR, we can simultaneously detect multiple pathogens. We also plan to use meta-genomics to identify unexpected pathogens present in a sample, giving us a broader and more detailed picture of emerging disease dynamics. From there, we plan to expand to Chachapoyas and Puerto Maldonado, two areas that, like Iquitos, are shaped by a strong human-animal interface and climate-related pressures. Testing WBE in different environments will help us understand how feasible this approach really is. We’re also working with global partners to standardize protocols so that our findings contribute to the growing international data sources on wastewater surveillance.
Reaching Indigenous and Rural Communities
One of our biggest priorities is extending WBE to Indigenous and rural communities, where traditional surveillance is even more limited. While in Iquitos, we met with the Director of Indigenous Groups in the Loreto Province, whose team is setting up a new research center in San Lorenzo, an area connected to seven Indigenous communities. This partnership is very exciting – we think it will help us expand WBE efforts to populations that are often the first to feel the health impacts of climate change but are rarely included in disease surveillance efforts. Just as importantly, it gives us a chance to learn from local knowledge and expertise, ensuring that our work is both meaningful and sustainable.
What’s Next?
By showing that WBE can work in climate-vulnerable regions, we hope to lay the foundation for scalable, cost-effective disease tracking worldwide. Over the next few months, we’ll be expanding our efforts in Peru, refining our methods, and sharing our findings with global partners. We’re excited about what’s ahead and look forward to keeping you updated as this work progresses.
