The Government of Iraq embarked on an ambitious infrastructure improvement plan based on our recommendations from a previously completed Strategic Plan. To determine the fiscal impacts of this project, we completed a Medium-Term Expenditure Framework model to determine the cost and benefits of implementing this 10-year, 600 million dollar program to build water and sewer infrastructure in Iraq. The analysis included projections of maintenance, operations, and capital cost and debt for two different development scenarios. The project resulted in a capital improvement programs to build or repair 40 water and wastewater treatment plants throughout the country.