This mode continues to be advocated by major donors, but it is becoming much more modulated and open to newly recognized stakeholders concerned with ecological impacts, dislocation of local people, often minorities in the respective countries, and other undesirable localized social, cultural and economic outcomes that, in changing who benefits and who loses, challenge the use of social cost-benefit analysis to defend large-scale projects. The MRC region, in particular, has been able to become open to many more voices in research and at international forums discussing policies and project outcomes. This has led to proposals for “integrated water resource management” (IWRM), which is now supported by many international donor/lender institutions, including the Asian Development Bank (GWP 2003, Abdul-layev et al.