What’s Driving the Health Crisis in Botswana?

Botswana Declares Public Health Emergency Amid Critical Medicine Shortages

Gaborone, August 26, 2025 — Botswana has declared a nationwide public health emergency as hospitals and clinics across the country face severe shortages of essential medicines, leaving patients without life-saving treatments.

President Duma Boko announced the emergency on Monday after weeks of growing concern from health professionals, who reported suspensions of non-urgent surgeries and empty pharmacy shelves. The shortages affect a wide range of critical treatments, including medications for HIV/AIDS, tuberculosis, hypertension, diabetes, cancer, asthma, and mental health conditions, as well as basic surgical supplies such as sutures and dressings.

“The situation is grave. We cannot ignore the urgent need for immediate intervention to protect lives,” President Boko said in a televised address.

Causes of the Crisis

Observers point to a combination of factors that have converged to push Botswana’s health system to the brink:

• Economic vulnerability: The country’s heavy dependence on diamonds, which account for more than 80 percent of export earnings and one-third of government revenue, has backfired as global demand for diamonds has plummeted.
• Procurement failures: The Central Medical Stores (CMS), the state agency responsible for medicine supply, has been accused of inflating prices. An internal taskforce found that CMS quoted annual supply costs more than five to ten times higher than independent estimates.
• International aid cuts: Reduced funding from global health partners, particularly the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), has strained programs once hailed for transforming Botswana into a leader in the fight against HIV/AIDS.

Government Response

To contain the crisis, the government has released 250 million pula (approximately £15 million) for emergency procurement of medicines. The Botswana Defence Force has been instructed to take charge of distribution to ensure supplies reach hospitals and clinics nationwide, including in remote regions.

A System Under Strain

Even before the current emergency, Botswana’s health system was struggling with long waiting times for specialist care — in some cases stretching up to two years. Tuberculosis, closely linked to the country’s high HIV prevalence, remains a major public health concern.

Healthcare workers report growing frustration and moral distress, saying they are forced to turn patients away or provide substandard care due to the shortages. “We trained to save lives, not to send patients home without medicine,” one doctor in Gaborone told local media.

The Road Ahead

While the emergency measures may offer short-term relief, analysts warn that Botswana faces deeper structural challenges. Economic diversification, robust oversight in procurement, and investment in supply chain resilience will be essential to prevent similar crises in the future.

Botswana has long been regarded as a regional success story, particularly in its battle against HIV/AIDS. The current crisis, however, serves as a sobering reminder of how quickly gains in public health can be undermined when financial and governance systems falter.