The food and water challenges to be faced in the Mediterranean Basin, particularly those on the southern and eastern shores, are daunting. They form a complex nexus of problems and require policies pursuing several important potentially conflicting goals at the same time: reducing or limiting food import dependency through increased agricultural production in environmentally sustainable ways while protecting the natural resource base and keeping food affordable for poorer populations. The worrisome trends affecting countries on the southern and eastern shores of the common sea can also have seriously negative consequences in the North which explains why the North-South collaboration has a long tradition in the region. But, as the case of water management institutions shows, ineffective advocacy for trade liberalization has led to conflicts and tensions on various issues and has distracted attention from potentially much more fruitful areas of collaboration.