In Botswana, a troubling healthcare crisis is unfolding, revealing the stark impact of economic instability on essential medical services. As the country grapples with drug shortages and rising unemployment following a significant downturn in diamond prices, vulnerable citizens like Boitumelo Mosege are paying the price. The 53-year-old mother of four, diagnosed with hyperthyroidism, has struggled to access her prescribed medication, leading to dire health consequences.
The Human Cost of Drug Shortages
Boitumelo Mosege’s story is emblematic of a broader issue affecting many in Botswana. After falling ill in late 2023, she was diagnosed with a condition that requires consistent medication. Yet, since her diagnosis, she has only intermittently received the necessary treatments. With a monthly medication cost of 2,000 pula (£113) and a household income reliant on her children’s sporadic income and her mother’s pension of 1,400 pula (£77), Mosege has gone without her medicine for months.
“I felt like I had lost my life right there,” she reflected, recalling the moment she was told to purchase her medication out of pocket. “I felt suicidal.”
Nearby, Kelly Jansen, 39, dedicates her time to caring for her 83-year-old father, Gerhardus, who requires a wheelchair and other medical supplies. Their financial strain is palpable, as they spend nearly a third of his pension on necessary medications. Jansen hopes to secure an electric wheelchair, expressing her longing for a return to independence. “I want my life back,” she stated, underscoring the emotional toll of their situation.
A Declining Economy and Its Consequences
The current healthcare crisis in Botswana has roots in a wider economic downturn, exacerbated by a significant drop in diamond prices—down by 60% over the past four years. Once a powerhouse of economic growth, Botswana’s fortunes have waned, triggering a public health emergency declaration from President Duma Boko in response to the dire shortage of medical supplies.
In an opinion piece published earlier this year, Boko highlighted the dysfunction within the Central Medical Stores (CMS), the agency responsible for health procurement. Thabo Lucas Seleke, a health policy expert at the University of Botswana, echoed these concerns, stating that the CMS has been a “breeding ground for corruption,” with issues longstanding since a 2010 government report called for urgent reforms.
While Botswana was once celebrated for its rapid economic growth and effective public health programmes, the current crisis starkly contrasts its past. The country’s GDP per capita, which stood at $7,695 (£5,697) in 2024, is now overshadowed by deteriorating healthcare outcomes, including higher maternal mortality rates than in comparably wealthy nations.
Rising Unemployment and Struggles for Middle-Class Families
The economic malaise has not only impacted healthcare; unemployment has surged to 21% as of March 2025, with nearly 29% of young adults aged 15 to 35 unable to find work. Oratile Olorato Kgatle, a 26-year-old aspiring public relations professional, has faced a disheartening 18 months without a single job interview, leading her to seek psychiatric help to cope with her declining mental health.
Similarly, Phenyo Tanka, a 39-year-old mother of four, has faced her own challenges. After her husband lost his job as a mining engineer, the family was forced to cut back on dining out and let go of their domestic worker. Tanka, who graduated in agriculture in 2011, has struggled to secure a job in her field. Nevertheless, she remains determined, selling homemade cakes and aspiring to launch a toilet paper factory to support her family and inspire her daughters to pursue their independence.
Why it Matters
The ongoing crisis in Botswana serves as a stark reminder of the interconnectedness of economic stability and public health. As the nation grapples with rising unemployment and healthcare shortages, the most vulnerable populations bear the brunt of these challenges. The situation underscores the urgent need for systemic reforms in healthcare procurement and economic diversification away from reliance on diamonds. Without these changes, the lives of many citizens, like Mosege, Jansen, and Tanka, will continue to be marked by uncertainty and struggle, highlighting the critical importance of addressing these issues for the well-being of all Botswanans.
