Lack of sanitation is a major global crisis. While progress has been promised, with Millennium Development Goal 7 committing governments to halving the number of people without access, the reality on the ground is scandalous - with around one in three people in the world lacking basic sanitation.

This report, drawing on case studies from Burkina Faso, the Democratic Republic of Congo, and Madagascar, highlights barriers to delivering improved sanitation and hygiene and suggests how the international community and national governments should respond.

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