Water -- the resource itself as well as the irrigation and water supply services derived from it is important for every country. It is fundamental to human health, wellbeing, productivity, and livelihoods. It is also essential for the long-term sustainability of ecosystems. Here, in the Middle East and North Africa (MENA) region, the most water-scarce region of the world, good water management matters even more than it does elsewhere. The report suggests that MENA can meet its water management challenge. People have a very real need for water for drinking and for household uses. This domestic use, however, accounts for less than ten percent of a typical country's water consumption. Every country in the region has enough water resources to meet domestic needs, even accounting for the larger populations expected in the future. And policy decisions can help improve the way drinking water and sanitation services are delivered so that people get the services they need. The bulk of a typical country's water consumption goes to agriculture. This demand depends on such factors as the structure of the economy, people's consumption preferences, agriculture and trade policies, and how efficiently water is used. These factors can be influenced by policy choices. Similarly, countries can protect their environmental quality with policy and institutional choices. The necessary policy changes are far from easy. Yet they are essential, and, when coupled with improvements in accountability to the public, water resources and services will support communities and promote economic development and bring benefits to the entire population.