India is making good progress in increasing access to Water Supply and Sanitation (WSS) infrastructure in both urban and rural areas, but is lagging behind expanding access to service that is reliable, sustainable and affordable. This report analyses the main reasons for the gap between infrastructure and service and presents a series of recommendations for gradually improving the reliability, sustainability and affordability for the WSS service. It draws on the findings and recommendations of two background papers on the urban and rural water supply and sanitation sectors.