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Some 2·4 billion people lack access to safe sanitation. The potential of new technologies to address this need in low- and middle-income countries has been under-addressed in research, programming and policy. Despite the global efforts to improve access to sanitation, there has been insufficient attention to the role of transformative technologies to respond to these needs. There is an urgent need for innovation, in particular for safe faecal sludge management, not least to secure its benefits for health and well-being. This paper provides a short review of evolving technologies that are being developed to treat human faecal sludge together with insights into the use and implications of such technologies. A case study on the toilet reinvented by Loughborough University is presented, which uses hydrothermal carbonisation processes. The paper concludes with essential considerations for guiding national policymakers, the private sector, sanitation programme implementers and donors focused on improving access to safely managed sanitation.

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