There is a global sanitation and water crisis and governments are failing to act. This report looks at the current international response to this crisis and highlights the low political and financing priority given to sanitation and water. It shows that: overall, aid is rising but the share given to sanitation and water is in decline; sanitation and water are vital to health and education yet are given a low priority by both donors and aid recipient governments; aid is not going to the poorest regions or countries. Less than a quarter of aid to water and sanitation goes to the Least Developed Countries; and donors are increasingly investing in large-scale schemes in urban areas which are not benefiting the poor.