Ten municipalities in the Helsinki Region North (a.k.a. Central Uusimaa Region) have organised their regional co-operation in key development themes through KUUMA co-operation concept. MDI conducted an evaluation for current council period of 2013–2016. According to MDI’s e evaluation, KUUMA co-operation has played an important role in the compilation of the common will and voice in the region. During this council period, co-operation has focused on major infrastructure issues (especially transport and land use). Through KUUMA co-operation this pack of 10 small and medium sized municipalities is now considered as a respectable negotiating partner with the metropolitan area and the state authorities. As for the future, MDI sees two possible paths: even stronger focus on fewer themes, which requires will and skill to make shared choices. Another alternative path is the consolidation of municipalities, which is also a viable option when the structures around are changing due to major reforms in health and social services as well as in regional government. MDI continues sparring in two workshops to be organised in January-March.