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A cocktail of land-based sources of pollution threatens coral reef ecosystems, and addressing these has become a key management and policy challenge in the State of Hawaii, other US territories, and globally. In West Maui, Hawai'i, nearly one quarter of all living corals were lost between 1995 and 2008. Onsite disposal systems (OSDS) for sewage leak contaminants into drinking water sources and nearshore waters. In recognition of this risk, the Hawaii State Department of Health (DOH) is prioritizing areas for cesspool upgrades. Independently, we applied a decision analysis process to identify priority areas to address sewage pollution from OSDS in West Maui, with the objective of reducing nearshore coral reef exposure...