‘I want my life back’: drugs shortages lay bare economic impact of diamond crash in Botswana Botswana’s public healthcare system is facing severe drug shortages, forcing citizens like Boitumelo Mosege to purchase expensive medication themselves due to a dysfunctional procurement agency and an economic downturn linked to declining diamond prices. The country’s reliance on diamond exports, once a source of prosperity and universal services, has become a vulnerability as global demand shifts and the economy contracts, leading to increased unemployment and hardship. This crisis affects individuals across society, from farmers to those with chronic illnesses and young job seekers, highlighting the broader economic challenges Botswana faces.

• Severe shortages of essential medicines and medical supplies are plaguing Botswana’s public healthcare system.
• Patients are being forced to pay for their own medication, with costs reaching thousands of pula monthly.
• The crisis is linked to a long-standing dysfunctional health procurement system, the Central Medical Stores (CMS).
• Botswana’s economy, heavily reliant on diamond exports, has suffered a multi-year downturn due to falling diamond prices.
• This economic malaise has led to rising unemployment, with a significant impact on young adults.
• Despite past wealth, other healthcare outcomes have not kept pace with economic growth, and recent economic contractions are worsening the situation.
• The government declared a public health emergency due to medicine shortages.