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PATH — Using environmental surveillance to help control COVID-19 outbreaks in low and middle-income countries

By Avinash Mishra, Investment Director, and May Lew, Investment Associate  |   Posted 3rd March 2021

The Global Innovation Fund is partnering with PATH, a non-profit organisation working to develop and scale solutions to solve the world’s most pressing health challenges, as they lead a series of research pilots in Malawi, Pakistan, Nepal and Indonesia to monitor the presence of COVID-19 in low-income populations and share that valuable data to inform governmental response plans.

PATH will use GIF’s $868,000 grant to expand their use of Environmental Surveillance, or ES, which involves testing wastewater samples to detect pathogens. ES has been used successfully to monitor infectious diseases such as Polio and may be a powerful tool to control COVID-19 outbreaks as it can detect both symptomatic and asymptomatic cases in communities. ES also has the potential to complement national surveillance efforts in countries with limited capacity to test and trace.

To date, most of the recent COVID-19 ES studies have been concentrated in high-income country contexts with closed, municipal sewage systems and the public health community is still learning how best to apply ES in low-income country contexts where inadequate or non-existent sewerage infrastructure complicates sample collection and analysis. In many developing countries, the lack of awareness and evidence, funding, regulations and technical know-how also makes the process a challenge.

PATH will work with local partners on data collection projects in four countries and develop ES methods for effectively monitoring Covid-19 in low-resource settings so regional and national governments can have early warning of an outbreak, better target their interventions, and then monitor their impact.

In partnership with Michigan State University, PATH will also establish a Data Center to analyse the data from field countries. The Data Center will also be a platform to share data and methods with the wider research community and public health authorities worldwide with the goal of supporting the integration of ES into their long-term COVID-19 management plans.

Another key aim of this leveraging existing environmental surveillance communities to bring together researchers, implementation partners and other stakeholders in order to promote knowledge and learning exchange, sharing of replicable models, and scaling in new geographies.

Importantly, PATH will also evaluate the cost-effectiveness of conducting ES and produce data GIF expects to help drive future uptake of this innovation by public health authorities worldwide. While the early warning and monitoring of the pandemic is the most pressing need, ES can also potentially help track the evolution of the virus and the data can feed into programs for development of vaccines and assess the success of vaccination campaigns, which has already been successfully applied for the poliovirus immunization.

GIF is joined in co-funding this programme alongside the Bill and Melinda Gates Foundation and enable the expansion of PATH’s research pilots to a fourth country.