Community-Led Total Sanitation (CLTS) represents a radical alternative to conventional top-down approaches to sanitation and offers hope of achieving the Millennium Development Goals. In contrast to state-led initiatives to improve sanitation that tend to focus on hardware and subsidies, CLTS emphasises community action and behaviour change as the most important elements to better sanitation. CLTS focuses on enabling the local community to analyse the problems of faecal-oral routes of disease spread, and of finding locally appropriate, rather than externally prescribed, solutions. Through exercises such as transect walks, mapping of open defecation sites, and the various routes of disease spread (e. g. through flies and animals), as well as calculation exercises aimed at drawing villagers’ attention to the amount of faeces they are ingesting, powerful emotions of shame and disgust are triggered. A process is ignited where people are moved into action, drawing on local resources and knowledge to construct sanitary facilities that fit their particular needs and desires, within the constraints of household priorities and resources. Pioneered by Dr. Kamal Kar, an independent development consultant, in Bangladesh in 1999, CLTS is currently being implemented in more than 30 countries across the globe, in Asia, Africa and Latin America.

However, like all success stories, CLTS still faces a number of challenges in terms of its scope and impact. There is a need to map out and understand the social, technological and ecological dynamics of CLTS implementation in order to better appreciate the long-term sustainability issues of CLTS and realise its full potential for improving people’s lives and well-being.