More people are affected by the negative impact of poor water supply and sanitation than by war, terrorism, and weapons of mass destruction combined, according to a paper published in this week's issue of The Lancet. Almost 4 000 children are killed everyday by this "silent humanitarian crisis". Dr Jamie Bartram, co-ordinator for the World Health Organisation's Water, Sanitation and Health Programme recommends the dramatic scaling up of efforts, involving the expansion of safe drinking water and sanitation coverage in order to meet the Millennium Development Goal (MDG) water and sanitation target by 2015. Bartram's article in The Lancet is the fifth in a series of papers summarizing the key conclusions of the Millennium Project – a three-year independent advisory effort commissioned by UN Secretary-General Kofi Annan to review progress of the MDG.