Drug shortage pushes patients to breaking point
Nnasaretha Kgamanyane | Monday May 4, 2026 09:23
Across the country, the underprivileged are hit hardest. Unable to afford private pharmacies, many are sent home with prescriptions they cannot fill, forced to watch their conditions worsen while they wait for stock that does not come.
In clinics from Gaborone to the remote settlements of Kgalagadi, it has become common for patients to move between facilities in search of medication. Only a few succeed. Others, after days of searching and spending scarce money on transport, simply give up. Nurses say they are left to explain the inexplicable, handing over referral notes instead of pills. “We feel helpless,” said one health worker in one of the Gaborone clinics. “You see a diabetic patient with dangerously high sugar, and you have no metformin. You tell them to try the next clinic,” she added.
The shortages are not limited to antibiotics or painkillers. Critical drugs for chronic diseases are also affected. Patients living with hypertension, diabetes, and mental health conditions report weeks without treatment, increasing the risk of strokes, amputations, psychotic episodes, and relapse. For those on mental health medication, the gap in supply can undo months of stability. Caregivers say some patients have become aggressive or withdrawn after being forced off treatment.
The situation inside the wards is equally dire. At Princess Marina Hospital, the country’s main referral facility, admitted patients say the hospital provides little beyond a bed. “All they are provided with is accommodation,” said one patient currently in the medical ward. “We have to ask relatives to bring us hot water to bathe. If you do not have someone in Gaborone, you suffer. Sometimes even gauze or gloves must come from home.” Families now budget for basic hospital supplies alongside transport and food when a loved one is admitted.
Responding to the outcry, Acting Permanent Secretary in the Ministry of Health, Dr Christopher Nyanga, acknowledged the challenges but said supplies are gradually improving.
“The Ministry of Health continues to source medicines and medical commodities to ensure that all public health facilities have an adequate supply of essential medicines,” Nyanga said. “Though the medicines' availability is not optimal yet, it is slowly improving as we get more of the long-term consignments arriving,” he added.
The Ministry expects to receive over 170 line items in the coming weeks as the situation in the Middle East improves and fuel costs stabilise. Critical medications, including long-awaited antiretrovirals, are also arriving. “Some of these items have been either out of stock or low stock. Therefore, their impact will be felt as soon as they reach our facilities,” he said.
To avoid over-reliance on a single source, the Ministry has contracted other international aggregators in Europe, the Americas, and the region, in addition to UAE-linked consignments. “This approach of sourcing from diverse regions provides a buffer to maintain supply continuity,” Nyanga said. “The Ministry remains committed to exploring alternative procurement channels to prevent any recurrence of the severe medicine shortages experienced in the recent past.”
As of the end of March 2026, availability remained below target. At Primary Hospitals, vital medicines accounted for 65% and essential medicines for 53%. District Hospitals recorded 60% for vital medicines and 50% for essential medicines. Referral Hospitals were at 64% for vital medicines and 62% for essential medicines. The availability of consumables and medical devices was 60% at Primary Hospitals, 59% at District Hospitals, and 68% at Referral Hospitals.
Nyanga said the Ministry is “aggressively modernising its procurement strategy” through a direct procurement model aimed at streamlining how essential goods reach patients. Immediate interventions include bridging current gaps through local procurement when it offers speed or cost-efficiency.
Following a gazetted exemption on 11 February 2026, the Ministry has officially integrated international humanitarian aggregators into the supply network. The move is designed to stabilise the market through increased availability, drive down consumer pricing by introducing healthy international competition, and generate significant savings by removing unnecessary intermediaries.
The long-term plan goes further. “We are currently finalising long-term supply agreements that were previously hindered by regulatory bottlenecks,” Nyanga said. “Our ultimate goal is to transform Botswana into a regional aggregator and manufacturing hub. By shifting from a consumer to a producer, we will secure our own national supply while driving economic stability across the region.”
He cautioned that establishing new production capacity takes time, but said these foundational steps will ensure consistent, affordable access for all in the future.
Although the Ministry cannot give specific timelines, Nyanga said confidence is growing. “Given the steps that have so far been taken, the Ministry is positive that the situation will continue to improve. This is definitely not a permanent situation.”
For now, patients with hypertension, diabetes, and mental health conditions remain the most affected by the shortages. Until the consignments reach clinics and wards, many Batswana will continue to choose between transport, food, and medicine, or go without treatment entirely. Health workers warn that each week of delay risks preventable complications, hospital admissions, and deaths.