Further work is required to harmonize the methods and standards used to monitor the treatment and disposal of excreta from on-site sanitation systems. Water pollution has worsened since the 1990s in almost all rivers in Latin America, Africa and Asia. Increasing political will to tackle pollution at its source and treat wastewater will protect public health and the environment, mitigate the costly effects of pollution and provide additional water resources. Wastewater is an undervalued source of water, energy, nutrients and other recoverable by-products. Recycling, reusing and recovering waste can alleviate water stress. A coordinated, coherent and pragmatic policy environment is therefore required for the multiple stakeholders involved in the monitoring, collection, treatment, recycling and reuse of wastewater to engage in safe and innovative practices.