The Total Sanitation Campaign (TSC) was a community-led, people-centred, demand-driven and incentive-based programme ideal to address India's rural sanitation crisis, or so it seemed. But policy failed to translate into practice and outcomes were remarkably poor. In the 2011 census data showed 31% sanitation coverage in 2011 (up from 22% in 2001), far from the 68% reported by the Government. The decade has witnessed progress slowing down and the number of rural households without latrines increasing by 8.3 million. This article draws on evidence from two coordinated studies in four Indian states. It aims to explore the dichotomy of TSC policy and practice, its causes, and the potential of the new sanitation campaign, the Nirmal Bharat Abhiyan (NBA). The study found that TSC implementation was unaligned with the programme's guiding principles. In reality the TSC was government-led, infrastructure-centred, subsidy-based and supply-led, leading to poor outcomes. The reasons behind the theory–practice gap include low political priority; flawed monitoring; distorting accountability and career incentives; technocratic and paternalistic inertia; and corruption. In the new NBA, despite promising changes such as a stronger demand creation focus, key issues hampering implementation remain ignored. It is thus doomed to fail, burdened by known past hurdles.

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