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To achieve the aims of the Millennium Development Goals, signicant investments will be required to increase sanitation coverage and improve the management of human excreta. The United Nations Millennium Task Force on Water and Sanita-tion put forward 10 crucial actions that would be needed, and among these is a pledge for governments to support sanitation solutions that are technically, socially, environmentally and nancially appropriate (1).In eastern Asia one of the key aspects to be considered when promoting appropriate sanitation solutions and design-ing health education programmes is the use of human excreta as an agricultural fertilizer. The centuries old tradition of using human excreta on farmland has been abandoned in Europe, but is still widespread in east Asia, especially in China and Viet Nam. Although there may be negative health consequences of the use of excreta as fertilizer, it is argued here, in reference to the current situation in Viet Nam, that if this is a com-mon practice among farmers, then sanitation programmes and hygiene campaigns must acknowledge its existence and design systems that allow for excreta to be used in the safest way possible.

Successful sanitation promotion must recognize the use of latrine wastes in agriculture--the example of Viet Nam.