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Over 80% of the land mass on Earth is in a watershed that drains directly to the ocean, making it the ultimate sink for anthropogenic pollution. Pollution in the ocean is already negatively impacting human health, economic prosperity for ocean-based businesses and marine ecosystems on which humans depend for essential ecosystem services. A multipronged, integrated approach that targets different actors and motivations at different stages along value chains is needed. Solutions will come from innovative policies, support for research and innovation, investment in wastewater and solid waste infrastructure and shifting mindsets and behavioural practices.