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Berlin – The monitoring of certain pathogens in wastewater in Germany is to continue in 2025 despite the provisional budget management. “Sewage monitoring will continue,” a spokesman for the Federal Ministry of Health (BMG) said today upon request.

Follow-up financing will therefore be ensured by the BMG and the Federal Environment Ministry (BMUV) in cooperation with the Robert Koch Institute (RKI) and the Federal Environment Agency (UBA) during the provisional budget management in 2025.

The monitoring was set up by the RKI and UBA as part of the AMELAG project (wastewater monitoring for epidemiological situation assessment). The trigger was the SARS-CoV-2 pandemic. AMELAG expires on December 31, 2024. According to the RKI, around 23 to 24 million euros of the funding amounting to 27 million euros have been used so far.

So far, more than 160 sewage treatment plants in all federal states have been sampled. This covers a third of the population in this country, the RKI reported in the summer. The weekly reports from the Influenza Working Group at the RKI on acute respiratory diseases have so far presented wastewater data on SARS-CoV-2 and, for a few weeks now, also on influenza.

According to the RKI, the BMG introduced the intended follow-up financing into the parliamentary budget process. But due to the break in the government coalition, it can be assumed that the process will no longer be concluded this year.

In the past few weeks, hundreds of people have signed a petition to secure funding for wastewater monitoring. Its importance is justified, among other things, by the documentation and perception of infection events such as SARS-CoV-2. Even against the background of the spread of the highly pathogenic bird flu virus H5N1, it is important to ensure monitoring as an early warning system nationwide.

The BMG now further explained that it currently expects costs of around five million euros per year for the planned sustainable financing for respiratory pathogens (COVID-19, influenza, RSV) at the federal level.

The states and municipalities share responsibility “and therefore also have financial responsibility for the sampling and, if necessary, analysis of the samples from the sewage treatment plants,” a ministry spokesman said.

The federal government is responsible for surveillance and therefore in particular for data analysis/evaluation and publication of the data at the federal level.

According to the RKI, additional research is continuing into how wastewater monitoring can be used to monitor antimicrobial resistance and other pathogens in wastewater. “This requires additional funds that will have to be negotiated by a future government as part of the 2025 budget preparation process,” said the RKI. This will be required, among other things, by the European Municipal Wastewater Directive from 2028.

Pathogens or components thereof can enter wastewater via stool, urine and saliva. The data allows conclusions to be drawn about the trend in infection dynamics. They are considered important in addition to other monitoring systems.

One advantage is that the results are independent of the number of doctor visits and tests carried out. However, there are also some limitations, such as the severity of the disease cannot be depicted and the incidence, prevalence or under-reporting cannot be accurately determined, as RKI experts noted. © ggr/aerzteblatt.de