A clarion call for greater investment in global sanitation.

Diarrhoeal disease continues to be a leading cause of death in developing countries, particularly affecting children in the first 5 years of life. The hindrance on global development resulting from inadequate sanitation is recognised in the MDGs, and a target to halve the proportion of people without access to basic sanitation by 2015 has been established. Although global sanitation coverage increased from 49% to 59% between 1990 and 2004, on the basis of current performance the shortfall will be almost 600 million people by the target date in 2015. The vigour with which other MDGs have been approached has not yet been mirrored in tackling the sanitation shortfall. Indeed, in sub-Saharan Africa the number of people with unsafe sanitation is increasing. Lancet 2007;370:1592-3.