Poor sanitation contributes to the spread of disease in many developing countries. Efforts to provide subsidized toilets have faced resistance due to cultural reasons. To increase uptake, some are suggesting a market-based approach. Many people don't see the need for toilets, hindering supply and distribution. The UN's goal to improve access to clean water and sanitation by 2015 is off-track. While progress has been made in clean water access, many still lack improved sanitation facilities. By 2015, billions will still lack proper sanitation, with a significant number resorting to open defecation. Free toilets are often not used, according to experts.