Systematic wastewater-based monitoring is another tool to complement conventional surveillance for public health policy decisions. It helps to recognise changes at an early stage and to follow-up pandemic developments . The concentration of SARS-CoV-2 RNA in wastewater showed the trends of COVID-19 infections in the population without individual testing. Working with all wastewater treatment plant operators in Albania, GIZ Water Programme initiated in collaboration with the German Technologie Zentrum Wasser (TZW), and the Agricultural University of Tirana (AUT), the development of a wastewater monitoring system on SARS-CoV-2, other viruses, and antimicrobial resistance (AMR). This laboratory is centrepiece for wastewater-based epidemiology in Albania.

Main challenge was to interlink partners from the water and health sectors to an intersectoral and inter-ministerial working group until the Early Warning System for public health became functional for the consultancy of the Albanian Government.