Conventional sanitation approaches are rather inappropriate and expensive ways of providing a satisfactory solution to increasing wastewater problems in developing countries. This paper looks at the financial and environmental implications of the sanitation approaches adopted in Zimbabwe, and from the weaknesses identified, suggests a paradigm shift in which wastewater treatment is geared towards resource recovery and reuse. It was observed that unsustainable methods continue to be used because of deficient institutional arrangements and irrational technology choices made in the past. Natural treatment methods were recommended because they are low cost, easy to operate and maintain, and allow for the re-use of effluent. To achieve this requires a responsive institutional and funding mechanism backed by realistic legislation.