There are 1.7 billion people in Asia and Pacific without access to improved sanitation—far behind the MDG target. Sanitation is central to the larger development agenda, but it remains to be one of Asia’s principal socioeconomic challenges: social—because it deals with public health and human dignity; and economic— because of the tremendous losses from environmental and human impacts. Open defecation, inadequate sanitation facilities and discharge of untreated wastewater into water bodies threaten the health of local people as well as affect livelihoods, ecosystems, and water bodies, the latter of which we rely on for drinking, bathing, swimming, and fishing, among others. A paradigm shift is therefore required towards new approaches that include technological innovation, comprehensive package of financing, credit enhancement and delivery mechanisms, and performance-based and business-oriented solutions, and ensuring that investments are appropriate to the communities and industries they serve. More than ever, it is crucial to increase efforts to improve sanitation by 2015 and beyond. We need to identify doable solutions and opportunities, and agree on actions that will make sanitation happen. But neither of these two activities—identifying opportunities and committing to action—can happen without a solid knowledge base to work from.