Abstract
Wastewater surveillance (WWS) provides valuable information about infectious disease trends in communities. The Centers for Disease Control and Prevention (CDC) created the National Wastewater Surveillance System (NWSS) in 2020 to coordinate and inform WWS programs in state, tribal, local, and territorial (STLT) health departments. As this system grew from eight initial implementing partner jurisdictions to implementers in all 50 states, seven territories, and some tribal communities, so too did ethical questions and a need for clear, shared priorities for the WWS field. Geographic coverage and pathogen testing capabilities expanded quickly over time, emphasizing the need for a standard set of ethical priorities at a national level. These priorities are essential to ensure the responsible use of WWS data for public health action while addressing potential ethical risks. Academic, international, and independent implementers have previously defined ethical priorities and considerations for WWS. This foundation of work also highlighted the need for a practical, applied ethical framework for WWS that incorporates the perspectives of WWS expert groups.