In Bangladesh, millions of rural poor are currently drinking water that is contaminated with high levels of arsenic. Although the problem was described as the worst mass poisoning in history, little has been achieved to resolve it. Among the few projects that are being implemented, even fewer have managed to reach the poor and to implement water supplies and health support systems that last. The Arsenic Mitigation and Research Foundation sees the challenge as one of implementation and governance. It has worked for over 10 years to suggest viable long-term strategies and discourage damaging development programs and policies.