Last year, medicine shortages in Botswana forced me to declare a public health emergency. Patients went without treatment – not because health workers failed them, but because the system did. For a nation committed to universal, free-at-the-point-of-use healthcare, it was a moment of hard truth.
Even outwardly strong public health systems can be fragile. As donor assistance bites across the continent, governments cannot afford to delay building out resilience and today. As a middle income-country, Botswana was only ever a peripheral recipient. Yet when diamond revenues – the country’s primary export – fell amongst a market downturn, the fiscal shock was no different in effect.
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