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Lake Titicaca is one of the largest freshwater lakes in the world, located over 3.800 meters above sea level in Bolivia. Despite the vastness of this water resource, people around the lake and the islanders do not always have access to water, which causes many conflicts. The Bolivian Plurinational State has promoted in its 2009 constitution and on the international scene a right to water and the principle of Vivir Bien, a principle based on harmony between people and with nature. In this context, we study the strategies adopted by the people and the solutions proposed by public policies to improve access to water. We question the stakes of the Vivir Bien philosophy. Is it able to reduce these environmental inequalities?