This report uses the latest data available to measure each country’s progress toward MDG Target 10 and analyzes whether it will be achieved. The results show a mixed picture. Some countries have already met the target; others are on track; others are likely to miss it in 2015. Some countries even show a decrease in coverage. The analysis in this report figures the economics of change—how much it will cost to ensure each country in the region meets MDG Target 10. Considering the economic returns of improved access to water on productivity and growth at both macro and micro levels, the paper argues that “it is the height of economic irrationality to not invest in these vital services.”