In the year 2000, the UN General Assembly resolved the Millennium Development Goals (MDGs), and all the Member States of the UN pledged to take any measures to get the MDGs achieved. Concerning water supply and sanitation, a rough calculation clearly tells that it is impossible to meet the MDGs by just copying and pasting the traditional technology as it has been developed in the industrialized countries. Novel concepts and technologies have to be developed, tested and made available which allow fast implementation for a reasonable price, and which provide high treatment efficiency, reliability and robustness. Based on the latest estimates on population growth and migration rates it appears that top priority should be given to investments in the water infrastructure of municipalities. Introduction of water re-use systems should be favoured to avoid over-exploitation of local water resources. Suggested are step changes of the infrastructural system components with emphasis on technology innovation. Many small steps are often more effective than a single big one. In the attempt to quickly improve local situations specific attention should be paid to modern physico-chemical methods based on membrane technology. Decentralized wastewater treatment and re-use methods should be installed simultaneously to the construction of new houses. Further development of methods for separate collection and treatment of particularly composed waste streams should be encouraged. Wastewater should be rated as a source of valuable materials rather than a nuisance. Technology development should proceed hand-in-hand with the development of the societal, economical and political framework. Concerted actions are necessary to make novel technology function. Otherwise, meeting of the MDGs will remain an illusion.