In the mid-1990’s, researchers discovered naturally occurring arsenic in drinking water drawn from shallow tubewells across large areas of rural Bangladesh. Twenty years later, an estimated 20 million people in Bangladesh still drink water contaminated above the national limit. An estimated 43,000 people die each year from arsenic-related illness in Bangladesh, according to one study. The main causes of death are cancers, cardiovascular disease, and lung disease. Nepotism and Neglect is based on information collected from 134 interviews across seven rural districts in Bangladesh, including with people suspected of having arsenic-related health conditions, caretakers of government water points, government officials, and staff of nongovernmental organizations. It finds the official response to arsenic contamination is failing. A significant proportion of public resources for the arsenic response are used in areas where the risk of arsenic contamination is low. Politicians often undermine the allocation of new wells funded by the government by diverting these life-saving public goods to their political supporters and allies. Finally, there is a serious lack of quality control in arsenic mitigation projects; in a small but significant number of cases, government water points are themselves contaminated with arsenic above the national standard.