The Millennium Development Goals (MDGs), designed to combat global poverty and hunger, protect the environment, improve health and sanitation and promote education and gender equality, were agreed at the UN Millennium Summit in September 2000. The importance of access to clean water in the overall MDG process has been highlighted and shown to contribute to all other goals and targets. Goal 7 target 10 aims to “halve, by 2015, the proportion of people without sustainable access to safe drinking water and improved sanitation”, compared with 1990. The aim of this MDG is clear and considered to be achievable in most countries. However, it is argued that the base data upon which the targets are set and against which progress will be measured can be problematic, partly because of reliance on poor government information and also on the apparent need of the UN to have a consistent base year and set of definitions across the world.

In this paper, we report the findings of a major water and sanitation survey conducted in Kazakhstan designed specifically to quantify the current level of access, providing the base upon which to determine implementation priorities and against which to measure progress. As well as providing country-specific information the survey highlighted several important issues that have more general relevance. We raise three major questions associated with Target 10: how to define “access”, how to define “improved source” or “improved sanitation” and whether 1990 is always an appropriate base year. Moreover, we argue that there is need to reconsider the way progress is monitored and that the focus on global comparisons is detrimental to making real progress. In conclusion we argue that improving water supply and sanitation can be done in a way that is (1) appropriate for the country, (2) feasible (and fairly easy) to monitor progress and (3) more likely to be accepted by government as there is a sense of relevance.