When nature calls, we need a toilet. However, in Kenya, there are still 5.6 million people, 12 per cent of the population, who do not have access to one. Geographically, there are significant disparities in the availability and access to proper sanitation, with 15 per cent of people living in rural areas defaecating in the open compared to three per cent in urban areas. This reality means that human faeces, on a massive scale, is not being safely disposed of. In many parts of the country, open defaecation poses serious health concerns, such as cholera, with devastating effects. Poor sanitation also has broad impacts beyond public health, including living and working conditions, nutrition and economic productivity. It also affects girls’ education. In schools where there are neither safe nor private toilets, girls often drop out. Every year on November 19, World Toilet Day places sanitation at the centre of the development agenda. Much more than toilets alone, World Toilet Day is about dignity, gender equality and safeguarding our health and well-being. Kenya has adopted the Sustainable Development Goals. SDG 6 specifically aims at ensuring that everyone has a safe toilet and open defaecation is eliminated by 2030. Under this vision, Kenya committed to ending open defaecation by 2020. This requires county governments to plan how to support households and communities to invest in latrines and handwashing facilities. While notable efforts are underway across the country, some counties have already made remarkable progress. Busia and Kitui counties have been declared open-defaecation free, while Siaya and Isiolo are nearing the finish line. Isiolo county began its journey in 2016. At that time, 44 per cent of the county’s 143,000 people practised open defaecation. In addition, a 2014 World Bank analysis estimated Isiolo to be losing Sh139 million in revenue annually due to poor sanitation, mostly attributed to healthcare expenses and lost wages. Since 2016, Isiolo and Unicef have invested resources for public health officers, community health workers and volunteers to engage with communities and households about the dangerous spread of disease-causing germs from exposed human faeces. Increased awareness of the link between deadly disease outbreaks and open defaecation from the lack of latrines and poor hygiene practices is leading to action. Today, 154 of the 263 villages in Isiolo are free of open defaecation, meaning all households have a latrine and a handwashing facility with water and soap present and use it. Despite recurrent drought, flooding and cases of insecurity, Isiolo remains committed with active and persistent teams on the ground to ensure that the county eliminates open defaecation by March 2019. Investing in sanitation makes sense. For every dollar (Sh100 ) invested in sanitation, $5.5 (Sh565 ) is returned as savings derived from communities needing less healthcare, travelling less to clinics and missing less work due to illness. With a price tag of Sh30,000 per village, dedicated teams of health workers engage communities in promoting the uptake and usage of proper sanitation and hygiene. This saves lives, restores dignity and reaps significant economic returns. We call upon other counties to follow the example of Isiolo and press for progress in providing access to safe toilets for every household. Bold financial investment, alongside sustained support for communities to eliminate open defaecation, can have a significant transformative effect on the lives and health of millions. On World Toilet Day, we renew our commitment along with other development partners to support the Government of Kenya to realise the tremendous health benefits, economic opportunities and, most importantly, the human dignity that proper sanitation provides. Kuti is Isiolo governor while Schultink is Unicef Representative in Kenya