Botswana Grapples With 81,000 NCD Cases Amid Drug Shortages

President Advocate Duma Boko stood before residents gathered at Monarch kgotla in Francistown on a July afternoon and delivered a sobering accounting: roughly 81,000 people across Botswana are living with non-communicable diseases—diabetes, high blood pressure, cervical cancer, and others—conditions that demand consistent medication and care. The number itself was striking enough. What made it more urgent was what he said came next: the public health system tasked with treating these people is running short of the drugs they need.

The shortages are not accidental, Boko explained. They are the legacy of how government had bought medicines in the past. Companies had overcharged without justification. Procurement procedures had been flawed. The result was a system starved of essential pharmaceuticals at the moment when demand was highest. Yet the President offered reassurance too. The shortages, he said, would soon disappear. Government was working intensively to fix what had broken.

The problem extended beyond mere supply chain failure. Months earlier, the government had disposed of pharmaceuticals worth millions of Pula—a loss that Boko framed as evidence of deeper institutional rot. The incident revealed systemic mismanagement, he said, the kind of thing that erodes public trust and wastes resources that could have gone to patients. Correcting it was now a priority.

Beyond health, Boko addressed the broader welfare landscape. The old age pension, he promised, would rise to 1,800 Pula once the economy strengthened enough to bear the cost. For families receiving the Child Welfare Grant, payments would be backdated to April, when the program had started—a measure meant to ease immediate hardship. The Ipelegeng programme allowance, which supports vulnerable workers, would also be reviewed and adjusted as fiscal conditions permitted. Each promise came with a caveat: the economy remained under pressure, and improvements would come gradually.

In education, the government had launched a school refurbishment initiative, beginning with 21 selected schools across the country. Boko called education the backbone and foundation for every child, framing the investment as essential to long-term development. Other initiatives aimed at improving livelihoods were also in motion, though details remained sparse.

What emerged from the Francistown gathering was a portrait of a government confronting inherited dysfunction while trying to manage immediate need. Eighty-one thousand people were waiting for reliable access to medicine. Pensioners and welfare recipients were waiting for promised increases. Schools were waiting for repairs. The President's message was that these problems were being taken seriously, that past mistakes were being identified and corrected, and that relief was coming—though not immediately. The economy, he suggested, was the constraint. How quickly it recovered would determine how quickly lives improved.