Safe drinking water near to the home and adequate household sanitation save poor households time, reduce illness and increase a sense of well being and dignity. Gram Vikas, a non-government organization working in one of the poorest states in India, recognized this key role and encouraged villages to agree to a pact - water and sanitation for every house in the village - in return for labour and a percentage of the costs. Fundamental to the process was a growing sense of empowerment, so that once the building was finished whole villages were ignited to drive their own development projects. This book describes how Gram Vikas engaged with new villages and carried out the programme, how costs were met by the households, government and donors, and the resulting impacts on health,education and livelihoods. Finally the question is asked: can this international award-winning approach be scaled - up to increase sustainable coverage of water and sanitation and combat poverty worldwide?