In Botswana, the economic fallout from a plunging diamond market is taking a toll on public health, leaving patients like Boitumelo Mosege struggling to access vital medications. Once heralded for its robust healthcare system, the country now faces severe shortages of essential medical supplies, forcing individuals to purchase their own treatments amid rising unemployment and economic instability.
A Personal Struggle for Health
Boitumelo Mosege, a 53-year-old former farmer from Molepolole, has endured months of suffering due to a lack of consistent access to her prescribed medications. Diagnosed with hyperthyroidism in late 2023, her condition has left her unable to work. With a monthly medication cost of approximately 2,000 pula (£111) and limited financial support from her children’s part-time earnings and her mother’s pension, Mosege has been unable to buy the necessary drugs for three months. “I felt like I had lost my life right there,” she expressed, revealing the emotional burden of her health crisis.
Nearby, Kelly Jansen, a 39-year-old caregiver for her 83-year-old father, faces a similar plight. Their family spends a hefty portion of his pension on medical supplies, including a blood pressure monitor and compression stockings. Jansen is actively seeking donations for an electric wheelchair to ease her father’s mobility challenges, stating, “I want my life back.”
The Government’s Response to a Health Emergency
In response to the alarming shortages of medical supplies, President Duma Boko declared a public health emergency in 2025, nearly a year after his administration ended decades of rule by the Botswana Democratic Party. The country’s health procurement system, particularly the Central Medical Stores (CMS), has been under scrutiny for its inefficiencies, with experts highlighting issues that date back over a decade. Thabo Lucas Seleke, a lecturer in health policy at the University of Botswana, remarked, “It is a breeding ground for corruption. It has not improved; it is getting worse.”
Boko attributed the crisis to a prolonged economic downturn fueled by a dramatic decline in diamond prices—Botswana’s primary export—by as much as 60% over four years. This downturn has been exacerbated by rising unemployment rates, which reached 21% by March 2025, affecting nearly a third of young adults aged 15 to 35.
Economic Decline and Its Wider Effects
The collapse of the diamond market has not only impacted healthcare but has also sent ripples through Botswana’s economy, which had once been one of Africa’s fastest-growing. The International Monetary Fund (IMF) reported a contraction of 3% in 2024, with continued struggles attributed to external pressures such as rising global fuel prices. Marisa Lourenço, an independent political risk consultant, noted that Botswana has limited economic buffers to absorb these shocks.
Despite its past successes in education and healthcare—once a beacon for HIV/AIDS treatment—the country now faces a crisis that threatens the well-being of its citizens. Botswana’s GDP per capita stood at $7,695 (£5,697) in 2024, ranking it among the wealthiest in Africa, yet disparities in healthcare outcomes persist, with maternal mortality rates lagging behind those of similarly affluent nations.
Resilience Amidst Adversity
Individuals across the country are feeling the strain of economic hardship. For Phenyo Tanka, a 39-year-old mother of four, the pressure has led to significant lifestyle changes, including cutting down on dining out and letting go of domestic help after her husband lost his job as a mining engineer. Despite her struggles, Tanka remains hopeful, selling homemade cakes and planning to establish a small factory to empower her daughters toward independence.
Similarly, Oratile Olorato Kgatle, a 26-year-old aspiring public relations professional, has faced job market challenges for 18 months. Her condition, Erb’s palsy, limits her mobility, making job hunting even more difficult. “I could feel that light just dimming with each day,” she reflected, highlighting the mental health implications of prolonged unemployment.
Why it Matters
The situation in Botswana illustrates the intricate connection between economic stability and public health. As the country grapples with the fallout from the diamond market collapse, citizens are bearing the brunt of a failing healthcare system. The need for systemic reform has never been more urgent, as the wellbeing of thousands hangs in the balance. Without immediate action to rectify procurement inefficiencies and bolster healthcare access, Botswana risks undermining its past achievements and the health of its population, revealing the fragility of even the most successful economies in the face of global market shifts.
