President Blames Supply Shortfalls after Surgeries are Suspended
The president of Botswana, Duma Boko, has issued a state of public health emergency after severe shortages of key medicines and medical supplies. The declaration was made following the suspension of non-emergency surgeries on August 4 due to shortages of drugs to treat hypertension, diabetes, cancer, asthma, eye diseases, sexual and reproductive health issues, and supplies such as bandages and sutures.
In a televised speech, Boko stated that the nation’s medical supply chain had broken down and committed 250 million pula (£13.8 million) to emergency drugs, which will be supplied under military supervision. He attributed the high cost of drugs to the state procurement body, Central Medical Stores (CMS), saying that middlemen were charging five to ten times higher than market levels.
The CMS had allegedly tendered 705 million pula for one year’s worth of basic medicines, whereas an emergency taskforce, which was newly established, brought a quotation of less than 80 million pula. “Under existing economic conditions, this situation cannot be sustained,” stated Boko.
Procurement Failures and Economic Strain
Experts cite CMS systemic problems, including corruption claims, missing procurement documents, and repeated delivery delays. University of Botswana lecturer Thabo Lucas Seleke cited long-standing dysfunction, saying annual auditor reports identified consistent failure in contract management and supply delivery.
The economic slump in Botswana is exacerbating the issue. The three-year price decline in diamonds, which represent about a quarter of GDP, a third of government revenue, and 80% of exports, has placed the nation in dire financial straits. In 2024, the economy declined an estimated 3%. The prolonged decline surprised both diamond firms and the government, leaving the health sector underfinanced and exposed, according to analysts.
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HIV Success Under Threat from Aid Cuts
Botswana has been a world leader in HIV/AIDS prevention, lowering vertical HIV transmission to less than 100 cases in 2023 and achieving the World Health Organization’s gold-tier classification. Nevertheless, the nation’s response to HIV has been impacted by reductions in US assistance announced in January, which had formerly funded approximately one-third of HIV spending through PEPFAR and the Global Fund. Part of the funding has since been reinstated, but gaps persist.
The health ministry also disclosed that it owes 1 billion pula to private health facilities and suppliers, again demonstrating the burden on the system. Local finances are being pinched and global assistance is not guaranteed, and experts advise immediate reform so that further public health crises can be avoided.
