This report analyzes how five megatrends (climate change, emerging and frontier technologies, demographic trends, inequalities, and urbanization) and their drivers, individually and in combination, transform societies and affect the ability of countries to achieve the SDGs. However, the Agenda is already offtrack. The devastating impacts of the COVID-19 (coronavirus) crisis have further diminished prospects for achieving the SDGs, with the greatest adverse impacts falling on countries and people least able to protect themselves, and already at greatest risk of being left behind. Consideration is given to the interlinkages among trends and how these trends can be fundamentally shaped by policy so that their individual and collective impacts support sustainable development in its various dimensions. The report concludes by identifying a range of policies and interventions that could be effective in shifting the evolution of the megatrends, and establishing the principles that should guide the choice of policies in countries.