In Botswana, a nation once celebrated for its robust economy and healthcare system, the consequences of a collapsing diamond market are now manifesting in severe shortages of essential medications and healthcare supplies. As the economy falters, individuals like Boitumelo Mosege and Kelly Jansen are left to navigate a broken system that has forced them to shoulder the financial burden of their medical needs.
Healthcare Crisis: A Personal Toll
Boitumelo Mosege, a 53-year-old former farmer, has been grappling with hyperthyroidism since late 2023. This debilitating condition has not only affected her health but has also rendered her unable to work. Despite Botswana’s promise of free public healthcare, Mosege has faced significant challenges in accessing her prescribed medications. Relying primarily on her mother’s pension of 1,400 pula (£77) and occasional piecework from her four children, she struggles to afford the 2,000 pula monthly cost for her medications.
After three months without her necessary treatment, she described the experience as life-altering. “I felt like I had lost my life right there,” Mosege lamented. “I felt suicidal.”
Similarly, Kelly Jansen, who dedicates her time to caring for her elderly father, faces a dire situation. With a third of his pension allocated to necessary medical supplies, Jansen is left searching for an electric wheelchair to improve their quality of life. “I want my life back,” she expressed, highlighting the emotional toll of her caregiving responsibilities.
Economic Factors Behind the Healthcare Shortages
The health crisis has been exacerbated by a public health emergency declared by President Duma Boko in 2025, following a significant decline in healthcare procurement efficiency. This deterioration has been linked to a prolonged economic downturn, largely attributed to a 60% drop in diamond prices over four years. Diamonds account for approximately 80% of Botswana’s exports, and the fall in demand has had cascading effects across the economy.
Boko has pointed fingers at the Central Medical Stores (CMS), the government agency responsible for health procurement, citing rampant inefficiencies and price inflation. Thabo Lucas Seleke, a health policy lecturer at the University of Botswana, voiced concerns about the systemic issues within the CMS, stating, “It is a breeding ground for corruption. It has not improved; it is getting worse.” Despite these claims, the health ministry has not issued any comments regarding the situation.
The Broader Economic Landscape
Botswana’s economic trajectory has been remarkable since its independence in 1966, transforming from one of the world’s poorest nations to one of Africa’s wealthiest. However, the current crisis starkly contrasts this narrative. The nation has recently seen its GDP per capita drop to $7,695 (£5,697) in 2024, and the International Monetary Fund (IMF) reported an economic contraction of 3% in 2024, followed by an additional 1% decline last year.
The rise in global fuel prices, driven by geopolitical tensions such as the US conflict with Iran, poses an additional challenge, as Botswana imports oil and lacks a diverse economic foundation. As a result, unemployment surged to 21% by March 2025, with youth unemployment reaching an alarming 29% among those aged 15 to 35.
Impact on Employment and Daily Life
The economic downturn is not limited to healthcare; it has also severely affected the job market and middle-class families. Individuals like Oratile Olorato Kgatle, who has been seeking employment in public relations for 18 months, have faced mental health struggles due to prolonged unemployment. “I could feel that light just dimming with each day,” she shared, illustrating the emotional toll of her situation.
Phenyo Tanka, a mother of four, has also felt the impact of the economic landscape. After her husband lost his job as a mining engineer, the family made significant lifestyle adjustments, including eliminating dining out and letting go of their domestic worker. Despite having graduated with a degree in agriculture in 2011, Tanka has been unable to find suitable employment in her field. Undeterred, she is venturing into entrepreneurship by selling homemade cakes and aspiring to establish a toilet paper factory.
Why it Matters
The unfolding crisis in Botswana serves as a stark reminder of the fragility of economic growth and the profound impact it can have on public health. As the diamond market struggles to recover, the healthcare sector’s failures become increasingly apparent, leaving vulnerable populations to confront the dire consequences. The situation calls for urgent reforms, not only to restore healthcare access but also to diversify the economy and reduce dependency on a single resource. The plight of individuals like Mosege and Jansen highlights the urgent need for systemic change to ensure that basic healthcare remains a right, not a privilege, in Botswana’s evolving economic landscape.
