"The current situation is inexcusable," said Maggie Catley-Carlson, chairperson for the Stockholm-based Global Water Partnership. Catley-Carlson explained that half as many people in the world have access to sanitation compared to those who have access to safe drinking water. "The reason the situation is allowed to continue is because those most affected by poor sanitation are the least powerful," she said.

One water-development success story in La Paz, one of the poorest capitals in Latin America, illustrates how fresh water has taken precedence over sanitation. By the end of this year, 100 percent of the population of La Paz will have access to clean water, while only 63 percent of the city's population will have access to sanitation.

During the discussion participants came up with novel ways to raise the profile of sanitation issues, but all agreed that sanitation needs to be tied directly to water development.

"Now there is a policy in South Africa that the water program will not be implemented without sanitation," said Kasrils, who spoke of a time in recent history that this was not the case.

In addition to linking sanitation directly to water projects, participants discussed equating sanitation with human dignity. In the past, sanitation has always been touted as a public health issue, but some of the ministers suggested that by relating sanitation to dignity, a powerful human emotion, more people would take up the cause.

"It is demeaning to a person, especially in an urban area, not to have access to sanitation," said Nitin Desai, Secretary General of the upcoming World Summit for Sustainable Development scheduled to take place next September in Johannesburg.

Dr. Klaus Toepfer, Executive Director of the UN Environmental Program, echoed the idea of relating sanitation and clean water to dignity.

"Let it be emotional," he said. "If you are handling water on a rational level, you are lost."

But just who would promote the idea of linking sanitation and water to dignity? Kasrils believes that the responsibility lies with local governments.

"In South Africa, unless the local government is involved then I can't see sanitation being discussed," said Kasrils, who knows from first-hand experience how much pride can result from acquiring your own outhouse. In a story which provided some comic relief during the discussion, Kasrils described what happened when he attended an unveiling ceremony of a "privy" built for a 60-year-old woman. Kasrils, as the government representative at the event, was afraid he would be expected to christen the "privy" in front of a large crown that had gathered to share in the excitement. Much to his relief, just as he was certain he would have to go inside, the crowd burst into a rendition of the national anthem, which was quite appropriate as the outhouse had been pained to look like the colorful South African flag.

As the round-table discussion wound down, the panel members and attendees discussed a draft outcome statement that had been drawn up before the discussion. Suggested changes were given and a few alterations were made, but most participants agreed that raising the profile of sanitation, and linking sanitation to water were the most critical points.

"Someone has to care," said Catley-Carlson. "Someone has to give a damn to make this happen." Judging from the passion in her voice and the commitment expressed by the other panelists and attendees, there are people who do care, and they are more determined than ever to make sanitation happen.