A decent toilet is an unknown luxury to half the people on Earth. An estimated 2.9 billion people lack of access to adequate sanitation, up from 2.6 billion in 1990. The percentage of people with access to sanitation has actually fallen in the developing world since 1990 as funding has declined and population has increased. The main result has been a rise in the cases of diarrhoea which kills nearly 2.2 million children every year, raising health care costs. Unplanned settlements lack public utilities mainly because of governments' unwillingness to acknowledge their existence.