Some of the critical needs that must be met to predict the effect of environmental change on waterborne disease include the following: 1) better knowledge of disease incidence and pathogen excretion; 2) better characterization of the pathogens in sources (e.g., combined sewer overflows, septic tanks) and these sources' vulnerabilities to climate change; 3) better monitoring of sewage indicators to gather source, transport, and exposure information (event monitoring); 4) improved understanding of sediments and other pathogen reservoirs; 5) more quantitative data for risk assessment; and 6) better health surveillance data. In turn, this information can be used to better use ground truthing in combination with remote sensing technologies as predictors of waterborne disease outbreaks.