To achieve the Millennium Development Goals for urban water supply and sanitation ∼300,000 and ∼400,000 people will have to be provided with an adequate water supply and adequate sanitation, respectively, every day during 2001–2015. The provision of urban water supply and sanitation services for these numbers of people necessitates action not only on an unprecedented scale, but also in a radically new way as “more of the same” is unlikely to achieve these goals. A “new paradigm” is proposed for low-cost urban water supply and sanitation, as follows: water supply and sanitation provision in urban areas and large villages should be to groups of households, not to individual households. Groups of households would form (even be required to form, or pay more if they do not) water and sanitation cooperatives. There would be standpipe and yard-tap cooperatives served by community-managed sanitation blocks, on-site sanitation systems or condominial sewerage, depending on space availability and costs and, for non-poor households, in-house multiple-tap cooperatives served by condominial sewerage or, in low-density areas, by septic tanks with on-site effluent disposal. Very poor households (those unable to afford to form standpipe cooperatives) would be served by community-managed standpipes and sanitation blocks.

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