This story was originally published in Dwell’s June 2009 issue.

On November 4, 2008, the night Americans voted for “change,” it was already the morning of November 5 at the World Toilet Summit and Expo in Macau. Several hundred engineers, entrepreneurs, bureaucrats, and bankers were talking toilets in the conference center at the Venetian, which is just like the Venetian Las Vegas, except most of the gamblers are from mainland China.

Outside the hermetically sealed air-conditioned casino complex, the weather was a sultry 80 degrees Fahrenheit. Taxis dropped off summit attendees at the front entrance, an arcaded affair adorned with faux frescoes. Obsequious men in synthetic gondolier costumes helped with oversize luggage—containing toilet prototypes, perhaps.

The summit, titled “Driving Sustainable Sanitation through Market-Based Initiatives,” was meant to appeal to money-minded people. Its host was Jack “Toiletman” Sim, a Singapore businessman who left the construction industry in the late 1990s to found another WTO, the World Toilet Organization. In his opening address, Sim explained that global sanitation is a trillion-dollar market that’s virtually untapped because 2.6 billion people worldwide currently don’t have toilets of any kind. He showed a photo of a roulette wheel. “It’s time for investors to take a chance,” he said.

Design, from hardware to underwear, is fundamentally about objects that mediate between the planet and our naked selves. In this light, the toilet is unique. It’s the physical receptacle and conduit for our most massive bodily contribution to planetary matter, which, if you haven’t guessed, is excrement: The average human being produces 1,200 pounds a year of feces and urine combined. Underscoring Sim’s speech, and the entire summit, was awareness that due to lack of toilets, each year 3.12 trillion tons of untreated human waste contaminate water supplies. Resulting waterborne illnesses, which prey mostly on children, kill seven thousand people a day.

The global sanitation crisis is what social scientists Rittel and Webber might call a “wicked problem”—the sort that can only be addressed through design. A solution could save 2.5 million lives a year. It would entail not just objects but infrastructures. The world has yet to wake up to the problem.

For people who have toilets, huge issues remain, like the astronomical cost of sewage treatment (in the United States, the EPA estimates about $20 billion a year). In fact, worldwide, about 90 percent of sewer effluent is dumped untreated. Then there’s the unknown cost of living on chemically treated tap water. In H2O and the Waters of Forgetfulness, philosopher Ivan Illich describes the 20th-century transformation of water from the “stuff that radiates purity” into “H2O…on whose purification human survival now depends. H2O is a social creation of modern times, a resource that is scarce and calls for technical management.”

“Forgetfulness” is an apt word to associate with toilets. Ecologists sometimes describe the “flush and forget” mindset: What household object can rival the toilet’s ability to make disgust disappear? The flush is not unlike a sigh of relief. Every day thousands upon thousands of tons of human waste ride the waters out to an unseen infrastructure. Toilets top the water-consumption chart in most U.S. households, and they use water that’s treated for drinking.

Toilets are also a brilliant invention—as crucial to modern times as the steam engine or the Tesla coil. By preventing proliferation of feces-transmitted disease, they enable large-scale, high-density cities to exist. For the billions without them, toilets are an icon of progress beyond reach, because they rely on infrastructures that 21st-century realities render impossible. Forty percent of the globe is already suffering chronic water shortages, so there won’t be enough to flush down toilets. The world has yet to find a commensurately urbane alternative.

Sim looked down from his podium at the multicontinental, interdisciplinary group that comprised his audience. “Trying to address this problem, we have been working in silos,” he said. “It’s time for us to work together.” He asked everyone in the auditorium to recite the Sanitation Pledge with one hand over their heart: “Sanitation is a basic human necessity,” the crowd read from the screen, in faint unison. “I have a responsibility in providing sanitation services. I can be your partner in providing sanitation.” The crowd shuffled into the networking lounge for a tea break.

Alongside the summit—a packed schedule of panel discussions where topics ranged from “Disaster Sanitation” to “Assessing Toilet Need”—was the expo, in which a motley group of dry toilet producers displayed their wares.

Dry toilets are, of course, the waterless variety. The most successful models utilize ecological sanitation, known as eco-san, a system in which urine and feces are collected separately, feces are composted, and both are reused as fertilizer. The process has existed for millennia but was revived recently in Scandinavia, where rocky land makes septic systems impractical. Through urine separation, these toilets solve all the problems that arise when troubleshooting a garden-variety composting toilet: excess moisture (human waste is 90 percent water), excess space (with dry materials added to absorb the moisture), and noxious odor (together, urine and feces produce much more smell than either on its own).

Eco-san toilets recover nutrients such as nitrogen and phosphorus from human waste. They close an environmental loop and turn waste into a commodity. Already, fertilizer is in such demand that U.S. sewer companies often sell their sludge to farms. It’s directly applied to crops, despite the fact that it consists of not only human waste but industrial effluent, since our system treats them all together. The implications on public health are dubious at best.

But eco-san toilets aren’t yet suited for cities unless they are incorporated in new buildings, such as some recently erected in Dongsheng, an eco-town in China. They need too much space for storage, and too much retrofitting for comfort. Their output, fertilizer, requires transport to the countryside. Still, the underlying concept—turning waste into a commodity through a low-energy, waterless process—seems key to solving the global sanitation crisis, according to Jack Sim. In the Venetian Macau, recently constructed for $2.4 billion, there are over 3,000 bathrooms. Circumstances raised the question: Could $2.4 billion have bought a new toilet design for the 21st century? It would have to be waterless, odor-free, and user-friendly.

And that might not be the end of it. Lourdes C. Fernando, a mayor from the Philippines, caused a stir in the “Capacity Building” panel when she stood up and said, “As a mayor, I know that you have to be able to sell a concept. We need to make toilets sexy. Like, maybe a toilet can have a theme. So people can sit on the toilet and be X-Men for five minutes.” For now the superheroes will have to wait.