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As cities grow and produce more waste, deciding where all the waste will go becomes a public health priority. Although many cities have reserved dumps for waste, the dumps are open. Therefore, converting these dumps to controlled and sanitary landfills is a critical step for protecting public health and the environment. This guide serves as a practical tool for waste managers in middle and lower-income countries to make gradual improvements in the short term by upgrading disposal of wastes at modest cost, while still providing acceptable levels of environmental protection. In the medium to long term, the target should be to achieve full sanitary landfilling along with comprehensive policies and programs to reduce waste generation and increase recycling when it is economically viable.