In the past, floods and investments in flood protection were mainly concentrated in the Valley of Mexico and the Southern Border, but the Central Gulf and Yucatan Peninsula are now also at risk. The hurricanes in 2010 affected 118 municipalities in Coahuila, Nuevo Leon, and Tamaulipas, 138 municipalities in the states of Campeche, Puebla, Veracruz, and 56 in the states of Chiapas and Oaxaca. Approximately 200 cities with a population of more than 10 000 inhabitants are located in river basins with high flood risks. However, policy implementation is uneven, river basin councils are not yet fully operational and the regulatory framework for drinking water and sanitation is fragmented. There is a particular need for efforts to increase the water productivity and the cost-efficiency of water policies.