Possibilities and Limitations for Conducting Wastewater and Environmental Surveillance in Refugee Camps Worldwide

Worldwide, most refugees and asylum seekers are hosted in low- and middle-income countries, often with insufficient resources for public health surveillance. Refugees and asylum seekers living in camps may be particularly susceptible to infectious diseases because of the overcrowding and inadequate environmental health conditions inherent in camps. We propose that broader implementation of wastewater and environmental surveillance provides possibilities to support the health of refugees, asylum seekers, and the communities that host them by enhancing infectious disease surveillance. Key considerations include overcoming operational challenges, avoiding additional stigma, ensuring governance structures are regularly updated, and ceasing surveillance if data are weaponized or actionable data are not produced. (Am J Public Health. 2026;116(8):1229-1233. https://doi.org/10.2105/AJPH.2026.308433).