A lot needs to be done, and many agreements and plans are being made. This is why many people from different countries are working together in small groups to address the various problems.
Once a year there is a very big meeting where all the main subjects are discussed. The details, that is to say the smaller points affecting a particular place or just one subject, are discussed and acted on in the small groups.
Along with the main treaty there are lots of smaller plans, like the High Water Action Plan. Experts who know a lot about that subject are working on it.