Public acceptability, bioethics, and legal governance of wastewater and environmental surveillance for measles in South Africa
- 1University of Louisville
Abstract
ObjectivesThis study investigates public opinion regarding the use of wastewater and environmental surveillance for measles in South African urban centres across ethical, legal, and public health policy themes, and maps these opinions onto existing bioethical and legal precedents.
DesignIn-person field survey.
SettingThree metropolitan catchment areas in Gauteng Province, South Africa (City of Tshwane, City of Ekurhuleni, and City of Johannesburg).
ParticipantsA sample of 100 adult community members residing or working within the selected sewer catchment areas.
Primary outcome measuresBaseline wastewater and environmental surveillance awareness, target-specific acceptability, spatial monitoring preferences, data-sharing comfort, and legal/privacy perceptions.
ResultsBaseline awareness of WES was low (19%). Support was high for monitoring a range of biological and chemical targets using wastewater and environmental surveillance. However, acceptability was dependent on spatial scale: 83% supported macro-level "city-wide" monitoring, whereas support fell to 28% for localized sampling (individual homes and schools). Institutional trust in data handling was high among scientific and public health bodies.
ConclusionsPublic acceptability of WES for communicable diseases, particularly measles, in urban South Africa is high but conditional upon macro-level data aggregation ("anonymity by aggregation") and governance by dedicated scientific entities. Given strong community support for measles surveillance and its alignment with the countrys bioethical and legal frameworks, the bioethical and legal requirements for this surveillance approach can be satisfied, paving the way for routine implementation of wastewater and environmental surveillance for communicable diseases.
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BibTeX
@misc{matanda2026public,
title = {{Public acceptability, bioethics, and legal governance of wastewater and environmental surveillance for measles in South Africa}},
author = {R. Matanda and R. H. Holm and S. Maposa and L. Rabotapi and M. Yousif and K. McCarthy},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.04.26362243},
url = {https://www.medrxiv.org/content/10.64898/2026.09.04.26362243v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Public acceptability, bioethics, and legal governance of wastewater and environmental surveillance for measles in South Africa
AU - R. Matanda
AU - R. H. Holm
AU - S. Maposa
AU - L. Rabotapi
AU - M. Yousif
AU - K. McCarthy
PY - 2026
DA - 2026/09/04
PB - medRxiv
DO - 10.64898/2026.09.04.26362243
UR - https://www.medrxiv.org/content/10.64898/2026.09.04.26362243v1
AB - ObjectivesThis study investigates public opinion regarding the use of wastewater and environmental surveillance for measles in South African urban centres across ethical, legal, and public health policy themes, and maps these opinions onto existing bioethical and legal precedents. DesignIn-person field survey. SettingThree metropolitan catchment areas in Gauteng Province, South Africa (City of Tshwane, City of Ekurhuleni, and City of Johannesburg). ParticipantsA sample of 100 adult community members residing or working within the selected sewer catchment areas. Primary outcome measuresBaseline wastewater and environmental surveillance awareness, target-specific acceptability, spatial monitoring preferences, data-sharing comfort, and legal/privacy perceptions. ResultsBaseline awareness of WES was low (19%). Support was high for monitoring a range of biological and chemical targets using wastewater and environmental surveillance. However, acceptability was dependent on spatial scale: 83% supported macro-level "city-wide" monitoring, whereas support fell to 28% for localized sampling (individual homes and schools). Institutional trust in data handling was high among scientific and public health bodies. ConclusionsPublic acceptability of WES for communicable diseases, particularly measles, in urban South Africa is high but conditional upon macro-level data aggregation ("anonymity by aggregation") and governance by dedicated scientific entities. Given strong community support for measles surveillance and its alignment with the countrys bioethical and legal frameworks, the bioethical and legal requirements for this surveillance approach can be satisfied, paving the way for routine implementation of wastewater and environmental surveillance for communicable diseases.
ER -