What drives political leaders to improve urban sanitation?

This report analyses the political challenge of improving access to sanitation in rapidly growing and developing secondary cities. We look at examples throughout history and across the world, and argue that while sanitation problems may appear to be technical in nature, without political incentives to solve them, progress cannot be made. Drawing on lessons from historical progress, we formulate a framework for understanding how improvements in urban sanitation take place. We then apply these principles to current sanitation challenges in two secondary Tanzanian cities, Mwanza and Arusha, to assess what could drive improvements there, and potentially elsewhere.