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Ned Breslin, CEO of Water For People (center) discusses drinking water and sanitation crisis at The Atlantic's Water Summit at the National Press Club. Louis Boorstin, Bill and Melinda Gates Foundation (left) and David Winder, WaterAid America (right) look on.

The MDGs aim to cut in half by 2015 the percentage of people without access to water and sanitation according to a baseline established in 1990. Even if the MDGs are met, there will still be substantial numbers of people without access to water (about 800 million) and sanitation (more than 1.8 billion) in 2015.

To focus attention and foster discussion on this important issue, The Atlantic hosted a "Water Summit" looking at progress toward the MDGs related to water and sanitation.

At the meeting there were several strong views about how to accelerate progress.

U.S. Sen. Dick Durbin, D-Ill., called the global water crisis "a quiet killer" and "a threat to global stability and the global economy and to America's national security." He outlined how his bill, the Water for the World Act of 2009, would help.

"The goal is to reach an additional 100 million of the world’s poorest people with sustainable access to safe drinking water and basic sanitation by 2015," said Durbin. "This is not an opportunity to create vast new programs but to refocus our foreign assistance efforts on a comprehensive, strategic series of investments. These are simple, common-sense steps that will make a real difference in people’s lives."

He added that the bill would target areas of greatest need; provide training, financing and technical assistance and build the capacity of poor countries to meet water and sanitation challenges. There are 26 Senate and 70 U.S. House of Representatives co-sponsors for the bill and Durbin said he is hopeful the bill will receive a hearing this year.

Louis Boorstin, director of the Water, Sanitation and Hygiene Initiative at the Bill and Melinda Gates Foundation, suggested big strides could be made by thinking of sanitation as an economic issue, not a social one, and particularly by focusing on increasing the demand for toilets.

"Sanitation is not about giving people toilets," he said. "It's about having people demand toilets so they use them."

He mentioned there are many stories in the developing world that tell of donors who have constructed toilets for free for families but the facilities end up being used as storage sheds because of lack of real "ownership." He added that "half the population of the developing world does not have safe toilets, of which half practice open defecation," and that Gates Foundation programs are about learning what is scalable.

He said one of their grantees is working on a demand-driven sanitation program to reach 4 million people but that the real goal is to learn how it might be possible to ultimately expand access to 40 million or even 400 million people with sustainable and affordable sanitation.

As a part of their strategy to increase demand for sanitation, the Gates Foundation is also providing grants to create marketing campaigns focused on toilets. One marketing firm from South Africa was engaged to start a campaign in rural Tanzania to make improved toilets more desirable in that culture.

Ned Breslin, chief executive officer of Water For People, called for a change in the debate and discussion around how to solve the world’s water crisis. He called for action to break the cycle of failed water projects by engaging the private sector and deploying safe water technologies coupled with innovative operation and maintenance approaches. He also stressed the importance of long-term monitoring of all water and sanitation projects.

"We have to stop having short-term celebrations -- when we first put in the (water) well -- and look what happens five years down the road," he said.

One of the ways Breslin says radical progress can be made is by constantly asking the question, "Can we create a service out of this?" For example, his group works to support "circuit riders," local independent contractors who service water infrastructure and ensure sustainable supply chains. By working over long periods of time with communities, Water For People generates the demand for water infrastructure maintenance within even very poor communities. Because of this, people start to value water services much like they do cell phones and are willing to pay the circuit rider for services rendered.

"We may find we can actually make a lasting dent in water poverty if we unleash the power of the local private sector," said Breslin. "That way people can focus their lives on other pressing challenges instead of wasting their days collecting water."