Bolivia's drinking water and sanitation coverage has greatly improved since 1990 due to a considerable increase in sectoral investment.

The country's second largest city, Santa Cruz de la Sierra, relatively successfully manages its own water and sanitation system by way of cooperatives.

According to the government the main problems in the sector are low access to sanitation throughout the country; low access to water in rural areas; insufficient and ineffective investments; a low visibility of community service providers; a lack of respect of indigenous customs; "technical and institutional difficulties in the design and implementation of projects"; a lack of capacity to operate and maintain infrastructure; an institutional framework that is "not consistent with the political change in the country"; "ambiguities in the social participation schemes"; a reduction in the quantity and quality of water due to climate change; pollution and a lack of integrated water resources management; and the lack of policies and programs for the reuse of wastewater.

[6] In the last decades, frequent changes of government resulted in several restructurings of the institutional framework to face the problems of the sector.

During that period two major concessions for water and sanitation were granted to the private sector: One in La Paz/El Alto to the Aguas de Illimani S.A. (AISA), a subsidiary of the French Suez (formerly Lyonnaise des Eaux) in 1997; and a second one in Cochabamba to Aguas de Tunari, a subsidiary of the multinationals Biwater and Bechtel in 1999.

[8] The revised norm permits the installation of more efficient and of lower cost condominial sewerage systems and helps to increase sanitation coverage with limited funds.

He nominated Luis Sánchez-Gómez Cuquerella, who was formerly an activist of the struggle against the privatization in Cochabamba, as vice-minister of Basic Services.

In May 2006 the government dissolved the regulatory agency SISAB, saying that it failed to properly regulate tariffs and that it lacked accountability.

[3] In November 2016, the worst drought in 25 years led to water rationing in La Paz and El Alto.

[13] Just two weeks into the crisis, Bolivia's Vice Ministry of Civil Defense estimated that the drought had affected 125,000 families and threatened 290,000 hectares (716,605 acres) of agricultural land and 360,000 heads of cattle.

In some cities, cooperatives (utilities owned by their consumers) are in charge of water supply and sanitation service provision.

The National Fund for Regional Development (FNDR) is the government's instrument for the targeting of loans destined for water and sanitation investments.

The water supply issue in Bolivia was the main theme of the James Bond movie Quantum of Solace.