2008 is a good moment to review where water and sanitation policies are heading. First, it is the International Year of Sanitation – a chance to give this neglected topic the attention it deserves. Second, the UK Department for International Development (DFID) launches a new Water and Sanitation Policy. And third, preparations are underway for the 5th World Water Forum in March 2009 under the theme Bridging Divides for Water. Climate change figures prominently on the agenda. This Opinion points out that water sector professionals often have a vision of the perfect water resources system. The problem is implementation. Many governments, for example, have failed to adopt sanitation and hygiene policies that are backed by sound evidence. The Opinion outlines the top priorities: making the case for sanitation in a non-technical way; extending access to affordable water and sanitation; tailoring the management of water resources to local realities and investing in water resource assessment; and ensuring that new climate funds do not undermine aid effectiveness, and investing in adaptation in ways that are pro-poor and environmentally sustainable.