Developing Resilient Nations - Towards a Public Heath Early Warning System via Urban Water Profiling (ReNEW)

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We are proposing an innovative solution to current problems with rapidly identifying and responding to deteriorating public health and environmental conditions in fast developing urban environments in LMIC countries, aiming to manage risks to public and environmental health relating to urbanisation, population growth, lack of infrastructure and the overarching challenge of climate change. We will establish a cutting-edge, interdisciplinary research capability, based on engineering and digital technology approaches, for real-time community-wide diagnostics and tuneable multi-hazard public health early warning system (EWS) with the ultimate goal of strengthening communities' resilience. We will do this through a focus on water from urban dwellings, which reflects the health status of a population and surrounding environment as it pools the endo- & exogenous products of that population. Real-time measurement of these specific hazard biomarkers in urban water from different communities allows for rapid evaluation of public health status, prediction of future crises, and thus enables mitigation strategies to be developed for either rapid or slow onset hazards, even before they manifest themselves with characteristic endpoints (e.g. mortality in the event of pandemics). Thus morbidity and mortality can be reduced and resilience and sustainability within the surveyed urban system significantly increased. In this cutting-edge project we will develop innovative tools for public health diagnostics and undertake a scoping study in the city of Stellenbosch to understand the requirements for the development and implementation of a multi-hazard EWS in South Africa and beyond. ReNEW tackles all four strategic objectives set by the Department for International Development (UK Aid, 2015) and it focuses on "strengthening resilience and response to crises: (...) science and technology spend on global public health risks such as antimicrobial resistance, and support for efforts to mitigate and adapt to climate change". The UK is committed to "tackling the great global challenges - from the root causes of mass migration and disease, to the threat of terrorism and global climate change - all of which also directly threaten British interests". ReNEW will address this through engineering novel integrated sensors for on-site monitoring and use of big data for modelling markers within the urban water system as part of an EWS. We will focus on infectious disease. 21st century has already seen the epidemic of SARS (2003), H1N1 (2009), Ebola (2014) and recently Zika virus (2015). The recent O'Neill report (2016) commissioned by the UK government urges that "by 2050, 10 million lives a year and a cumulative 100 trillion USD of economic output are at risk due to the rise of drug resistant infections. Most of the direct impact will fall on LMIC countries". This highlights global vulnerability to infectious diseases and shared global responsibility for surveillance and disease control. Easy to operate and cost effective EWSs are urgently needed to provide timely response and to tackle key public health issues in communities that need it most, and to reduce disease spread globally. Urban water profiling can provide such a response in real-time and, if linked with a timely response system, it could reduce burden on public health in LMIC and ultimately worldwide.