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Three presentations from Session 34 of the Greater Mekong Forum on Water, Food and Energy, co-hosted by IWRP, the GIZ-MRC Network for Sustainable Hydropower Development in the Mekong countries, the Natural Heritage Institute and Deltares. The Mekong region is undergoing significant change in water resources development for multiple purposes, including hydropower, agriculture, fisheries production and navigation. This also requires the management of the river and its life- and livelihood-giving ecosystems for long term sustainability. Without coordinated development and effective river basin management, the Mekong Basin is exposed to many risks to water resources and associated ecosystems, including floods and drought, deterioration of water quality, reduction of sedimentation loads and extinction of many aquatic species. This session provided an opportunity to recognize these challenges in river basin management and identify development and management needs to tackle these issues.