Developing a Community Response Plan for Community-Driven Wastewater Surveillance and Monitoring of Infectious Cancers in a Tribal Nation

In rural Tribal communities, timely detection of infectious diseases remains a significant public health challenge. The Wastewater Monitoring for Wellness Project, a collaboration between a Tribal health department, Tribal college, in-state university and the state health department, began a community-driven wastewater surveillance pilot study on the Rocky Boy’s Indian Reservation to detect pathogens linked to cancer (i.e., Helicobacter pylori and human papillomavirus). Using a Community-Based Participatory Research approach, the project developed a community response plan, educational materials, and a data dashboard to translate wastewater findings into public health action. The community response plan outlined roles, communication strategies, and response protocols to inform health care interventions and raise community awareness. This work addresses unmet surveillance of infectious cancers, promotes Tribal data sovereignty, and supports ethical surveillance practices. The project demonstrates that wastewater surveillance, when grounded in local partnerships with community-centered priorities and with respect for Tribal data sovereignty, can be an effective tool for early disease detection and prevention in Tribal public health systems.