The economic fallout from a dramatic decline in diamond prices has unveiled a severe healthcare crisis in Botswana, transforming the lives of many citizens as they grapple with medication shortages and a faltering economy. As the nation—once a beacon of growth in Africa—faces unprecedented challenges, the repercussions are felt most acutely by those dependent on public healthcare, which is rapidly becoming unreliable.
A Personal Struggle for Health
In late 2023, Boitumelo Mosege, a 53-year-old farmer from Molepolole, began experiencing alarming health issues. Diagnosed with hyperthyroidism, she has since been unable to continue her work, relying on sporadic financial support from her children and her mother’s pension. With her monthly medication costs amounting to 2,000 pula (£111), the lack of consistent access to prescribed drugs has left her in desperate circumstances.
“I felt like I had lost my life right there,” Mosege recounted, revealing the depth of her despair upon learning she would have to purchase her own medication. “I felt suicidal.” Her plight is mirrored by Kelly Jansen, a 39-year-old caregiver for her elderly father, who faces a similar struggle to afford necessary medical supplies.
Public Health Emergency Declared
The situation has escalated to the point where President Duma Boko announced a public health emergency in 2025, following a prolonged period of deteriorating healthcare services. This crisis has roots in the long-standing dysfunction of the country’s health procurement system, which has been plagued by inefficiencies and corruption, as noted by health policy experts.
Boko attributed the worsening conditions to the Central Medical Stores (CMS), the state agency responsible for health procurement. “It is a breeding ground for corruption,” asserted Thabo Lucas Seleke, a lecturer at the University of Botswana, highlighting that the agency’s issues have persisted for over a decade, with previous government reports calling for urgent reforms.
Economic Downturn and Rising Unemployment
The economic landscape of Botswana has been drastically altered by a collapse in diamond prices, which account for approximately 80% of the nation’s exports. Following a staggering 60% drop in natural diamond prices over the past four years, the International Monetary Fund (IMF) reported a contraction of 3% in the economy in 2024 and a further 1% decline last year.
The effects of this downturn are palpable, with unemployment rates soaring to 21% as of March 2025, disproportionately affecting the youth, with nearly 29% of individuals aged 15 to 35 out of work. Amidst this backdrop, the struggles of ordinary citizens like Oratile Olorato Kgatle, who has been job hunting for 18 months with no success, underscore the urgency of the situation.
The Need for Economic Diversification
Despite its previous status as one of the fastest-growing economies globally, Botswana’s heavy reliance on diamonds has left it vulnerable to market fluctuations. The current economic malaise has not only impacted healthcare but has also forced families to make difficult choices, such as cutting back on essentials. Phenyo Tanka, a mother of four, has had to forgo dining out and let go of her domestic worker after her husband lost his job in the mining sector.
Tanka’s story exemplifies the broader challenges faced by educated citizens in Botswana. With a degree in agriculture and no job prospects since graduating in 2011, she has pivoted to selling homemade cakes and dreams of establishing a toilet paper factory, hoping to inspire her daughters to pursue independence.
Why it Matters
The current healthcare crisis in Botswana serves as a stark reminder of the fragility of economic prosperity when it is not underpinned by a diversified economy and robust public services. As the nation grapples with the repercussions of its reliance on diamonds, the struggle for basic healthcare reveals the human cost of economic mismanagement. The urgent need for systemic reforms in both health procurement and economic diversification cannot be overstated; the wellbeing of Botswana’s citizens hinges on it.
