COVID-19 has highlighted and exacerbated many global health inequities. Emerging evidence suggests that SARS-CoV-2 can spread through fecal aerosols, making sanitation a critical part of the COVID-19 mitigation strategy and providing an opportunity to reflect on current challenges and opportunities related to global sanitation at large. Global sanitation interventions continue to fall short of their target expectations, leading to millions of deaths and illnesses worldwide. Eurocentric approaches to sanitation fail to account for sociocultural determinants of sanitation behaviors and health, leading to low sanitation intervention uptake. Global public health needs to take a decolonial approach to our research and practice, and meaningfully involve local communities to progress towards global health equity.