The report highlights the strategic importance of effective water and energy resources management in the Aral Sea basin for sustainable development in Central Asia, with 81% of the region's population living within the basin. The issue of water resources sufficiency and depletion has been on the agenda since the mid-1980s, and climate change, population growth, and development exacerbate the situation. However, the water-use efficiency indicator in the region's countries varies significantly, averaging $2.5 per cubic metre for the whole region, which is critically low. Underinvestment in the water and energy complex and insufficient regional cooperation among Central Asian countries are the key reasons for the region's low water and energy use efficiency and high economic costs. The report proposes five institutional solutions for effective regulation and development of Central Asia's water and energy complex, including open and constructive regional dialogue, improving existing institutions, establishing an International Water and Energy Consortium of Central Asia, involving financial operators, and channelling more resources into inter-country and intersectoral research.