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Botswana Declares Public‑Health Emergency After Clinics Run Out of Medicine
In a stark reminder that the global supply chain for lifesaving drugs remains fragile, Botswana’s president declared a public‑health emergency on 25 August 2025 after several clinics in the country reported that they were “running out of medicine.” The announcement, issued by the Office of the President, came after a cascade of warnings from the Ministry of Health, the Botswana Medicines Regulatory Authority, and a coalition of patient advocacy groups that expressed alarm at the growing gaps in essential drug supplies.
The Scope of the Crisis
The immediate shortages involve a range of critical medications, including antiretroviral drugs (ARVs) for people living with HIV, tuberculosis (TB) treatment regimens, malaria prophylaxis, and first‑line antibiotics. According to the Ministry of Health, more than 70 % of health facilities across the three southern provinces of Gaborone, Francistown, and Maun reported that at least one essential drug was out of stock by the end of the week.
HIV remains a leading public‑health challenge in Botswana. As of early 2025, roughly 20 % of adults are estimated to be living with HIV, a figure that is maintained through an extensive national ART program. “If we lose continuity of care for even a single month, the risk of viral rebound, drug resistance, and subsequent transmission increases dramatically,” said Dr. Motswedi Nkhwane, the country’s Minister of Health. The TB‑HIV co‑infection rate—reported to be above 5 %—has been a particular focus of the government’s prevention strategy.
The shortage also affected treatment for malaria and bacterial infections that require antibiotics such as amoxicillin and ceftriaxone. According to the Botswana Medicines Regulatory Authority, several national stock‑taking reports from the past quarter have flagged low inventory levels in rural health posts, a trend that accelerated when shipping delays were reported by the Botswana Pharmacy Distribution System.
Causes and Global Context
The roots of the emergency lie in a combination of global supply‑chain disruptions, rising production costs, and domestic procurement inefficiencies. Botswana, like many low‑ and middle‑income countries, relies heavily on imports from multinational pharmaceutical manufacturers and regional distributors.
A 2024 United Nations report on global pharmaceutical supply chains highlighted that COVID‑19 had permanently altered the dynamics of drug manufacturing, pushing many production facilities to prioritize vaccines and antivirals over chronic‑disease therapies. “Supply chain fragility was a silent threat that finally manifested in a public‑health crisis,” noted Dr. Anjali Patel, a WHO supply‑chain specialist who visited Botswana in early August.
In addition, Botswana’s procurement process—centered on centralized bidding—has faced criticism for being slow and inflexible, especially during emergencies. The country’s reliance on a single regional distributor for a significant portion of ARVs and TB drugs made it vulnerable when the distributor reported a production shortfall at its South‑African manufacturing plant.
Immediate Response Measures
To address the acute shortage, the government has taken several immediate actions:
Emergency Allocation of Funds – The President announced a $300 million emergency allocation from the national budget, earmarked specifically for purchasing critical drugs from alternate suppliers. This fund will be used to procure ARVs and TB medications from neighboring countries and from the Global Fund’s emergency reserves.
International Aid Request – Botswana has formally requested assistance from the World Health Organization and the Global Fund to Fight AIDS, Tuberculosis and Malaria. The request includes a plea for an emergency stockpile of antiretroviral and TB drugs that can be dispatched to affected provinces within 48 hours.
Distribution Task Force – The Ministry of Health established a “Drug Distribution Task Force” composed of senior officials from the Botswana Medicines Regulatory Authority, the Botswana Pharmacy Distribution System, and provincial health bureaus. The task force is tasked with realigning inventory across all facilities and ensuring that critical drugs are redirected from less‑busy to more‑pressured locations.
Patient Support Programs – To mitigate the impact on patients, the Ministry has activated mobile health units that will travel to rural clinics to deliver medications directly. These units will also provide counseling on drug adherence, an essential component of the national HIV program.
Procurement Reforms – The government has pledged to accelerate reforms that allow for “on‑demand” procurement of essential medicines, especially in high‑risk therapeutic areas such as HIV and TB. This involves setting up a fast‑track approval process for emergency purchases and establishing a multi‑supplier framework to avoid single‑source dependency.
Stakeholder Reactions
The patient advocacy community has largely welcomed the government’s decisive action but remains cautious. “We are grateful that the government has recognized the crisis, but the root cause must be addressed,” said Dr. Nandi Motlhadi, director of the Botswana HIV Patients’ Alliance. “Long‑term solutions must include diversifying our supply base, investing in local production, and improving inventory management systems.”
Pharmaceutical companies operating in Botswana have also responded. A spokesperson for the multinational drug manufacturer Sanofi, which supplies a significant portion of the country’s ARVs, said the company is “committed to ensuring uninterrupted supply for Botswana and is working closely with the Ministry to explore alternative sourcing routes.”
The United Nations Office for the Coordination of Humanitarian Affairs (OCHA) has released a statement noting that the declaration is a welcome step toward safeguarding the rights of patients. “The health of individuals in Botswana must not be compromised by preventable supply‑chain failures,” the statement read. “We urge all stakeholders to support the government’s emergency measures while also working toward sustainable supply‑chain solutions.”
Looking Ahead
The declaration of a public‑health emergency serves as a clear signal that Botswana is willing to mobilize substantial resources to address immediate drug shortages. Yet it also highlights the ongoing vulnerability of health systems in the face of global market fluctuations and supply‑chain fragility. The government’s next priorities will involve not only restoring adequate drug supplies but also building resilience against future shocks.
Key actions in the coming months include:
Expanding Local Production – The Ministry of Health is exploring partnerships with regional manufacturers to set up local production of generic ARVs and TB drugs, a move that could significantly reduce dependency on imports.
Digital Inventory Management – Implementation of a real‑time, cloud‑based inventory system across all health facilities is planned to provide better visibility and predictive analytics for medication needs.
Strengthening Global Partnerships – Botswana intends to deepen its collaboration with global partners such as the Global Fund, the African Union, and the World Bank to secure a steady stream of emergency funds and technical support.
Regulatory Reforms – Simplifying the regulatory approval process for new drug imports will be crucial in ensuring that alternative suppliers can be engaged quickly in future emergencies.
As Botswana confronts this unprecedented crisis, the global community watches closely. The country’s experience underscores a universal truth: the lifeline of public health is as strong as the most fragile link in the supply chain. The emergency response may avert immediate harm, but long‑term resilience will require coordinated policy shifts, investment in local production, and robust international cooperation.
Read the Full reuters.com Article at:
[ https://www.reuters.com/business/healthcare-pharmaceuticals/botswana-declares-public-health-emergency-clinics-run-out-medicine-2025-08-25/ ]