Many people might assume that poverty is the main reason. In 2013, the Mekong Region had a total population of about 334 million people1, which is almost equal to the population of the United States but with only one quarter of the area. The growth rate of smaller and emerging cities in the Mekong Region is creating enormous pressure on sustainable planning and management of urban regions. Cities are increasingly facing problems with air and water quality, rate of solid waste generation, and loss of biodiversity, as well as inequalities in economic and social development.