For the first time, the government has ranked 423 class 1 Indian cities on the basis of their sanitation standards, and it may come as no surprise that Mumbai ranks not just lowest amongst the four metros but with its 46th position falls behind even cities like Kanpur and Guntur. Navi Mumbai with 11th rank is the city with best sanitation in Maharashtra. The rating of cities was done under the National Urban Sanitation Policy and is part of an exercise started in 2009 to create awareness about sanitation. It covered almost 72% of India’s total urban population and each city was scored on 19 indicators such as public access to toilets, treatment of sewage, proper disposal of wastewater and elimination of manual scavenging. All cities were given scores out of 100 and colour-coded as green, blue, black and red (depending on their cleanliness). Mumbai scored 45 points and was categorized as a black city. In comparison Delhi came in fifth place with 61 points, Chennai was ranked 13th and Kolkata was placed 25th on the list. There were just four blue cities and 230 black ones followed by 189 red urban centres. This shows that almost all of India’s urban population is living in sub-standard sanitary conditions, which poses a risk to both its health and life. This has been demonstrated most recently by the outbreak of a malaria epidemic in Mumbai.