The safe disposal of human excreta is a basic need. At present more than 2.4 billion people worldwide lack access to improved sanitation, of which most live in Asia and Sub-Saharan Africa. The sanitation coverage for Sub-Saharan African is just 36%. In some countries, such as Ethiopia, less than one in every ten people has access to sanitation. This situation at the beginning of the twenty-first century is scandalous.

Lacking access to sanitation is associated with severe health risks. Diarrhoeal disease kills more than two million people every year. Most of these are children under the age of five. The burden of worm infections (intestinal helminths) causes anaemia and can stunt growth in children.

For millions of people lacking sanitation means not having any privacy or dignity. It puts women and girls in danger from sexual harassment and assault, especially after dark. It brings other social costs such as embarrassment when others visit and it brings economic costs from health care and lost earnings. It is with these statistics and shocking personal risks in mind that the Sanitation Theme of the Hygiene Centre has as its goal to:
‘Research and develop sustainable, cost-effective market-based
approaches to excreta management that lead to increased household sanitation coverage.’

When the Millennium Development Goal 7, Target 10 for sanitation was established in 2002, it raised international political stakes and generated real momentum for progress. New approaches were developed to accelerate coverage (UN Millennium Project Task Force 2005). With increased attention and broadened interest in sanitation, a more realistic view of the complexity, time, resources and effort needed to meet the challenge of large-scale sustainable changes in sanitation is now emerging.

In these web pages we explore some of the key problems the sector is facing that currently prevent MDG Goal 7 from becoming a reality; we suggest how thinking must change and develop a way forward that will lead to sustainable excreta disposal.