**
Botswana is grappling with a significant healthcare crisis, exacerbated by an economic downturn driven by a sharp decline in diamond prices, which form the backbone of its economy. The plight of patients like Boitumelo Mosege highlights the stark reality of a public health system that is faltering under pressure, leaving many to fend for themselves in a nation that once prided itself on universal healthcare.
Struggles for Access to Medicine
Boitumelo Mosege’s health deteriorated in late 2023 when she was diagnosed with hyperthyroidism. The 53-year-old, who previously worked as a farmer near Molepolole, has faced a mounting healthcare challenge since then. With her condition requiring consistent medication, she has found herself without the necessary prescriptions for months. “I felt like I had lost my life right there,” she recounted, reflecting on the despair of being told to purchase her own medication. The financial burden is heavy; she relies on her children’s sporadic earnings and her mother’s pension of 1,400 pula (£77) to cover the 2,000 pula monthly cost of her treatment.
Nearby, Kelly Jansen, a full-time caregiver for her elderly father, is similarly affected. Their situation exemplifies the growing healthcare struggles in Botswana, with a third of his pension consumed by medical supplies. Jansen’s quest for an electric wheelchair underscores the urgent need for support as she pleads, “I want my life back.”
The Economic Impact of Diamond Price Declines
The alarming shortages of essential medications prompted President Duma Boko to declare a public health emergency in early 2026—nearly a year after he assumed office, unseating a long-standing ruling party. The economic challenges facing Botswana have reached a tipping point, primarily due to a dramatic decline in diamond prices, which have plummeted by 60% over the past four years. As the nation’s exports predominantly rely on this sector, the repercussions have been severe, leading to increased unemployment and straining public health resources.
Boko has attributed the healthcare crisis to the inefficiencies within the Central Medical Stores (CMS), the state procurement agency responsible for sourcing medical supplies. Thabo Lucas Seleke, a health policy lecturer at the University of Botswana, has pointed out that the CMS has long been plagued by corruption and mismanagement, issues highlighted in reports dating back to 2010. “It is a breeding ground for corruption,” Seleke noted, indicating that the situation has only deteriorated over time.
Unemployment and Economic Austerity
The economic malaise has resulted in rising unemployment rates, with figures reaching 21% by March 2025, and youth unemployment soaring to nearly 29% among those aged 15 to 35. This crisis is not confined to the impoverished sectors of society; even middle-class families are feeling the pinch. Phenyo Tanka, a mother of four, has been forced to cut back on expenses after her husband’s redundancy as a mining engineer. She illustrates the broader struggle of many in Botswana who have seen their livelihoods evaporate due to the economic downturn.
Tanka’s ambition to establish a toilet paper factory shows resilience amidst adversity, yet her story is illustrative of a broader failure in Botswana’s economic diversification away from diamonds. As education and entrepreneurship struggles persist, many, like 26-year-old Oratile Olorato Kgatle, are left searching for opportunities that remain elusive. After 18 months of job applications yielding no interviews, Kgatle sought psychological help, reflecting the mental health toll that prolonged unemployment can inflict.
Why it Matters
The intersection of Botswana’s economic decline and systemic healthcare failures presents a pressing challenge for the government and its citizens. As the nation grapples with the dual burdens of a faltering diamond market and deteriorating public health services, the resilience of its people is being tested. The current crisis serves as a stark reminder that without substantive reforms and diversification strategies, Botswana’s path toward sustainable development may be jeopardised, leaving its most vulnerable populations at risk of further marginalisation. The ability to access essential healthcare services is not merely an issue of economic stability; it embodies the very essence of human dignity in a nation striving to uphold its legacy of progress.
