As of 2012, 2.5 billion people lack access to sanitation services and 15% practice open defecation. The most noteworthy example is Bangladesh, which has half the GDP per capita of India but has a lower mortality from diarrhea than India or the world average, with diarrhea deaths declining by 90% since the 1990s. Even while providing latrines is a challenge, people still do not use them even when available. By strategically providing pit latrines to the poorest, charities in Bangladesh sparked a cultural change as those better off perceived it as an issue of status to not use one. The vast majority of the latrines built were then not from charities but by villagers themselves.