Wastewater and Environmental Surveillance Summary for Antimicrobial Resistance (pilot)

  01 December 2025

The WHO Wastewater and Environmental Surveillance: Summary for AMR explains that monitoring antimicrobial resistance (AMR) and resistance genes in wastewater and environmental waters is technically feasible and can add important value to traditional clinical AMR surveillance. Early studies—mostly small and short-term—show promising correlations with clinical data, especially in hospital wastewater, suggesting that wastewater and environmental surveillance (WES) could help detect emerging or increasing resistance trends earlier. However, major uncertainties remain: methods are not yet standardized, environmental and animal sources can complicate interpretation, and there is limited evidence that WES currently leads to concrete public-health action. Overall, WHO concludes that WES is a promising complementary tool within a One Health approach, but it requires further development, validation, and integration with existing clinical and veterinary AMR monitoring systems.

Further reading: WHO
Author(s): WHO
Clean Environment  
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