Urine hygienised by storage is effective in eliminating microbial germs, particularly schistosomes, and inactivating their eggs. It is a credible alternative for combating bilharziasis. The EcoSan approach offers the prospect of eradicating both forms of bilharziasis (urogenital and intestinal) by covering all localities with a complete ecological sanitation system and selling hygienised excreta as fertiliser to farmers. Urine used as an agricultural fertiliser also improves yields, with the added advantage that it is a herbicide. This system is a lever for sustainable agriculture in Côte d’Ivoire.