The global community has set the goal of universal access to sanitation by 2030. In the face of limited progress, business as usual is not an option for sanitation sector actors. Through an expert consultation, this paper aims to shed light on the changes needed. Experts believe that in the past, sanitation was regarded as a taboo and a private issue, and given low political prioritisation. This resulted in inadequate financing, capacity and institutions. Programmes were implemented in an uncoordinated manner outside government systems. They focused on infrastructure, neglecting behaviour change or addressing it with blanket approaches. The poor remained unreached, especially in urban areas. Poor collaboration and insufficient learning hindered progress in the sector. However, experts also highlight that prioritisation has nowadays reached unprecedented levels, opening up opportunities for progress. A consensus is starting to emerge on how to address past blockages and on the key knowledge gaps and sector priorities, including focusing on how to deliver urban sanitation, ensuring government leadership and sector harmonisation, and getting better at changing behaviour. However, it will be even more crucial that the key institutions in the sanitation sector display leadership and move towards more collaborative, adaptive and learning-oriented ways of working.