Molecular Public Health for Infectious Disease Prevention and Control

Molecular technologies have transformed infectious disease surveillance, but their public health value depends on whether molecular signals can be converted into timely and effective action. Unlike molecular epidemiology, which primarily uses molecular variation to characterize distribution, relatedness, transmission, and evolution, molecular public health is defined here as an end-to-end operational framework that connects molecular evidence to population-level decisions, interventions, and evaluation. This narrative review integrates molecular detection, pathogen genomics, bioinformatics, metagenomics, wastewater and environmental surveillance, One Health monitoring, antimicrobial resistance genomics, multi-omics, and artificial intelligence. The framework progresses from detection and analytical interpretation to prediction, intervention, and feedback. Implementation maturity is heterogeneous: targeted PCR, short-read pathogen genomics, and bioinformatics-supported outbreak investigation are established in many defined use cases, whereas pathogen-agnostic metagenomics, multi-omics, and AI-enabled decision support remain more context dependent or emerging. Actionability is operationalized through analytical validity, epidemiological interpretability, sample-to-decision time relative to the intervention window, decision impact, and measurable post-intervention outcomes. Persistent barriers include sampling bias, uneven global capacity, incomplete metadata, insufficient standardization, governance concerns, and poorly defined trigger thresholds. The central criterion for the field should therefore be whether molecular information measurably improves prevention and control.