This report was prepared upon the request of the Secretary-General of the United Nations and in cooperation with the German Technical Cooperation Agency (GTZ). It presents an assessment of the achievements of ESCWA member countries towards improving the supply of safe drinking water and basic sanitation. It also highlights the major constraints and challenges impeding progress in implementing the Millennium Development Goals-related target of halving, by 2015, the proportion of people without access to safe drinking water and basic sanitation. Drawing on the principles of integrated water resources management (IWRM), the report proposes several policy options, legislative and regulatory reforms and measures needed to overcome those challenges and build the capacities of relevant national bodies in achieving progress in the supply of safe water and basic sanitation.