Failing systems, caused by fragmented, disorganised and uncoordinated government leadership, coupled with the ineffective application of already-scarce resources, mark the state of urban sanitation in most low-and middle-income countries. The two most critical results are that it impacts very negatively on the health and wellbeing of the urban poor and on all aspects of the intended or desired sustainability of sanitation systems. Against this background, this working paper outlines a 'whole-system approach' to urban sanitation by shifting the focus from building infrastructure or a project-driven implementation approach to providing and maintaining equitable and environmentally friendly services, championed and supported by the government and with sufficient resources allocated to ensure sustainability. This working paper proposes a step-by-step approach to unravel and tackle the very complex circumstances surrounding the need to provide sanitation in urban areas, particularly in densely populated areas and to the less affluent sectors of society.