In Botswana, the healthcare system is revealing cracks as the country grapples with the economic fallout from a significant decline in diamond prices. Patients like Boitumelo Mosege, who are reliant on essential medications, are now faced with stark choices as drug shortages escalate. The situation reflects broader economic challenges that have left many struggling to access basic healthcare services.
Patients Bear the Brunt of Drug Shortages
Boitumelo Mosege, a 53-year-old former farmer from Molepolole, has seen her health deteriorate due to insufficient access to her prescribed medication. Diagnosed with hyperthyroidism in late 2023, she has been forced to rely on her children’s sporadic earnings and her mother’s modest pension to manage her healthcare costs. “I felt like I had lost my life right there,” she lamented, recalling the moment she learned she had to purchase her own medication. With her monthly medication expenses reaching 2,000 pula (£112) and no income from farming, she has gone without for months.
Nearby, Kelly Jansen, who cares for her elderly father, is also feeling the strain. The 39-year-old spends a third of her father’s pension on medical supplies, including vital items like compression stockings. “I want my life back,” Jansen expressed, highlighting the personal toll of the healthcare crisis.
Economic Collapse and Healthcare Shortcomings
The dire state of Botswana’s healthcare system has been exacerbated by a public health emergency declared by President Duma Boko in 2025. This announcement came in response to widespread shortages of vital medicines and supplies, a situation that has been compounded by an economic downturn following a significant drop in diamond demand—the cornerstone of Botswana’s economy, accounting for 80% of its exports.
Boko has pointed fingers at the inefficiencies of the Central Medical Stores (CMS), the government agency responsible for health procurement, which he claims has driven up drug prices. Thabo Lucas Seleke, a health policy lecturer at the University of Botswana, corroborates this, stating that the issues within CMS have been known for over a decade. “It is a breeding ground for corruption,” he noted, indicating that reform is urgently needed.
The Economic Ripple Effect
Once one of Africa’s fastest-growing economies after discovering diamonds in the late 20th century, Botswana now faces unprecedented challenges. The International Monetary Fund (IMF) reported a 3% economic contraction in 2024 and a further 1% decline in the following year. With unemployment figures soaring to 21% overall and nearly 29% among young people, the impact of the downturn is felt across all layers of society.
The struggles are not limited to those reliant on healthcare. Individuals like Oratile Olorato Kgatle, a 26-year-old aspiring public relations professional, have found themselves unable to secure work despite numerous applications. Over 18 months, Kgatle has received no job interviews, leading to a decline in her mental health. “I could feel that light just dimming with each day,” she reflected, illustrating the human cost of economic stagnation.
Phenyo Tanka, a 39-year-old mother of four, has also felt the pinch. After her husband lost his job as a mining engineer, the family was forced to cut back on spending and let go of their domestic worker. Tanka, who has been unable to find a job in agriculture since her graduation in 2011, is now pursuing entrepreneurship by selling homemade cakes and dreaming of starting a toilet paper factory. “I want my daughters to know they can be independent,” she said, showcasing resilience amidst hardship.
Why it Matters
The ongoing crisis in Botswana serves as a stark reminder of how deeply interconnected healthcare and economic stability are. As the country struggles with drug shortages and rising unemployment, the human stories of those affected highlight the urgent need for systemic reform. The situation calls not only for immediate governmental action to rectify healthcare inefficiencies but also for a broader economic strategy to diversify away from diamond dependency. Without these changes, the vulnerable populations will continue to bear the burden of an economy in decline, risking their health and futures in the process.
