Water services in Pakistan's majorcities and urban centers remain fragmented andintermittent-no city currently has 24 hours of water supplyfor seven days a week. This impairs the ability of cities tosupport economic growth and meet basic needs. Faced by thischallenge, the Nazim of the City District Government ofKarachi (CDGK) suggested in mid-2004 that the Water andSanitation Program - South Asia (WSP-SA) help to arrange adiscussion about lessons for Karachi from Water andSanitation (W&S) services reform in large cities andurban areas elsewhere in the world. In follow updiscussions, it was agreed that although Karachi would bethe entry point, the workshop should also include discussionof similar challenges elsewhere in Pakistan. Key W&Sstakeholders from major cities in Pakistan, the centralgovernment and the provincial government of Sindh (whereKarachi is located) attended a two-day workshop in Karachion February 23-24, 2005. The WSP-SA facilitatedparticipation by several resource persons, includingpractitioners from Manila, Johannesburg, Phnom Penh and fromthe national water utility in Uganda. The formalpresentations and delegates' inputs all emphasized theinstitutional-rather than technical- nature of thechallenges around water and sanitation in Pakistani cities.This message also came through in a number of keynoteaddresses. A key lesson learned from the workshop is thatthere is no single solution or model for water managementthat can be applied everywhere. However, international andPakistani city experiences all highlight a number of factorscrucial for effective reform in most contexts. These factorsinclude the importance of reliable information; the need forperformance benchmarks and monitoring; the issue of keepingpolicymaking, regulation, and provision separate andtherefore ensuring a robust accountability framework;strong political leadership,; having a comprehensive plan;sticking to the principles, while being pragmatic instrategy; managing change processes; proving powerfulincentives; and the need to have resources to sustain reformplans and initiatives.