Botswana, once celebrated for its robust economy powered by diamond exports, is now grappling with a healthcare crisis exacerbated by economic downturns and persistent medication shortages. As citizens face the harsh reality of purchasing their own medicines, many are left vulnerable, highlighting the broader implications of the nation’s economic struggles.
Medication Shortages: A Personal Battle
Boitumelo Mosege, a 53-year-old former farmer from Molepolole, is emblematic of the dire situation. After falling ill in late 2023 with hyperthyroidism, she has struggled to maintain access to her required medication. Despite Botswana’s promise of universal and free healthcare, Mosege has only sporadically received her prescriptions. With her income reliant on her children’s occasional work and her mother’s modest pension of 1,400 pula (£77), the monthly cost of her medication, roughly 2,000 pula, has become increasingly unattainable.
“It felt like I had lost my life right there,” she expressed, recalling the moment she was informed she needed to purchase her own medication. “I felt suicidal.” Her story is not unique in a country where many are forced to choose between basic necessities and vital health supplies.
A Broader Economic Context
The economic backdrop of this healthcare crisis is deeply troubling. Following a significant downturn triggered by a collapse in diamond prices—down 60% over four years—Botswana’s economy has suffered. Diamonds account for a staggering 80% of the country’s exports, and the drop in demand has contributed to rising unemployment rates, which reached 21% as of March 2025.
President Duma Boko declared a public health emergency last year, citing shortages of essential medicines that have plagued the Central Medical Stores (CMS), the country’s health procurement agency. Issues with CMS have been noted for over a decade, with experts claiming it has become a “breeding ground for corruption.” The agency’s failures not only reflect a systemic problem but also illustrate how economic instability has impacted citizens’ health and well-being.
Personal Stories of Resilience
Kelly Jansen, 39, is another individual facing the brunt of these challenges. Caring for her 83-year-old father, who relies on a wheelchair, she spends a third of his pension on necessary medications and supplies. Jansen’s search for an electric wheelchair symbolizes the quest for dignity and improved quality of life in the face of adversity. “I want my life back,” she remarked, capturing the shared longing for normalcy among those affected.
The impact of the economic downturn has also rippled through middle-class families. Phenyo Tanka, a mother of four, has had to adapt to a new reality after her husband lost his job as a mining engineer. The family has stopped dining out and had to let go of their domestic worker. Tanka, who graduated with a degree in agriculture in 2011, has struggled to find employment in her field. Nevertheless, she remains determined, now selling homemade cakes and aspiring to start her own toilet paper factory, driven by a desire to empower her daughters.
The Impact of Unemployment
Youth unemployment has been particularly stark, with nearly 29% of those aged 15 to 35 out of work. Oratile Olorato Kgatle, 26, embodies the frustration many young people feel as she navigates the job market with limited success. After 18 months of applying for positions in public relations without a single interview, her mental health deteriorated to the point where she sought help. Kgatle’s struggle is a reflection of a broader issue in Botswana, where the promise of economic prosperity has not translated into job opportunities for the younger generation.
Why it Matters
The current situation in Botswana serves as a poignant reminder of the interconnectedness of economic stability and public health. The country, once a beacon of growth in Africa, now faces significant challenges that threaten the well-being of its citizens. The ongoing healthcare crisis underscores the urgent need for systemic reforms in both health and economic sectors to ensure that access to essential services does not become a privilege but a fundamental right for all. As Botswana navigates these turbulent waters, the resilience and determination of its people will be crucial in the fight for a better future.
