In Botswana, a public health emergency declared by President Duma Boko has illuminated the stark realities faced by many citizens due to an ongoing economic crisis. Patients like Boitumelo Mosege and Kelly Jansen are struggling to access essential medications, raising critical questions about the impact of the country’s diamond-dependent economy on healthcare provision.
The Human Cost of Drug Shortages
Boitumelo Mosege’s life took a dire turn in late 2023 when she was diagnosed with hyperthyroidism, leading to a debilitating condition that forced her to abandon her farming job near Molepolole, a town situated approximately 30 miles from Gaborone. The 53-year-old relies on the precarious income of her four children and her mother’s meagre pension to afford the necessary medication, which costs 2,000 pula (£112) monthly. However, a lack of consistent access to her prescribed drugs has left her struggling for survival.
“I felt like I had lost my life right there,” Mosege reflected on being told she would need to purchase her own medication. “I felt suicidal.” This sentiment is echoed by Kelly Jansen, who is dedicated to caring for her elderly father. The 39-year-old spends a significant portion of his pension on medical supplies. “I want my life back,” she lamented as she searches for an electric wheelchair to enhance her mobility and independence.
Economic Decline and Healthcare Failures
The crisis in Botswana’s healthcare system is symptomatic of broader economic challenges. In response to severe shortages of essential medicines, President Boko declared a public health emergency in early 2025, following a protracted downturn exacerbated by a collapse in diamond prices—a commodity that constitutes 80% of the nation’s exports. The International Monetary Fund (IMF) reported a contraction of 3% in 2024, indicating a failure to recover from the economic fallout of the COVID-19 pandemic.
Boko has attributed the crisis to systemic failures within the Central Medical Stores (CMS), the government agency responsible for health procurement. He noted that escalating drug prices have compounded the difficulties faced by patients. Thabo Lucas Seleke, a health policy expert at the University of Botswana, remarked that the CMS has long been plagued by inefficiencies and corruption, stating, “It is a breeding ground for corruption. It has not improved; it is getting worse.”
The Unemployment Crisis
The economic malaise has triggered a significant rise in unemployment, which reached 21% as of March 2025. Among the youth, the situation is even more dire—nearly 29% of individuals aged between 15 and 35 are currently without work. This has profound implications for families across the nation. Phenyo Tanka, a 39-year-old mother of four, exemplifies the struggle faced by many; her husband’s redundancy as a mining engineer forced the family to cut back on expenses, including firing their domestic worker.
Tanka, who has been unable to find work in agriculture since her graduation in 2011, has turned to entrepreneurship by selling homemade cakes, demonstrating resilience in the face of adversity. “I have two girls and I want them to know that they can also be independent, as ladies,” she asserted.
The Diamond Market’s Decline
Botswana’s fortunes shifted dramatically following the discovery of diamonds in 1967, transforming it from one of the world’s poorest nations into one of Africa’s most prosperous. However, the recent crash in diamond prices—down by 60% over four years—has severely impacted the economy. With consumers increasingly opting for cheaper lab-grown alternatives, the future remains uncertain for this once-booming sector.
The rise in global fuel prices, driven by geopolitical tensions, further exacerbates the economic challenges faced by this landlocked nation, which relies heavily on imports. Marisa Lourenço, a political risk consultant, warned that the lack of economic diversification has left Botswana vulnerable. “If we look at how much the economy contracted during Covid, it never really recovered from that,” she commented.
Why it Matters
The ongoing healthcare crisis in Botswana serves as a stark reminder of the fragility of an economy heavily reliant on a single commodity. The struggles of individuals like Mosege and Jansen underscore the human cost of economic mismanagement and the urgent need for systemic reforms in both healthcare and economic policy. As unemployment rises and access to essential services dwindles, the implications for Botswana’s future stability and prosperity are profound, compelling the government to reconsider its approach to both economic diversification and public health.
