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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 of 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 labor and a percentage of the costs.This book describes how Gram Vikas engaged with new villages and carried out the program; how costs were met by 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?