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Public hospitals and clinics are reportedly being prevented from soliciting donations of medicines and medical supplies from potential benefactors, Sunday Standard been informed. This is despite continuing shortages that have left patients struggling to access essential healthcare.

A health professional, who spoke about the situation in the public health sector, described conditions as dire, saying some facilities had gone for more than six months without critical medicines and were running short of basic supplies such as cotton wool.

‘The situation is super bad. That’s the honest, painful truth,’ the professional said.

‘Whatever is there is in very limited numbers. We have been without a lot of critical medication for almosta year now. We don’t even have cotton wool.’

The source said the shortages extended beyond medicines to include an acute shortage of blood. Public health facilities just cannot provide essential and potentially life-saving treatment.

The situation is compounded by reports that health facilities cannot independently approach potential donors for assistance, leaving them reliant on government procurement and supply systems that have so far failed.

The professional said public facilities were unable to purchase supplies or pay suppliers without authorisation from the Ministry of Finance, while outstanding payments to suppliers had reportedly accumulated to millions of pula.

‘We can’t buy or pay suppliers without authority from Ministry of Finance. Suppliers are owed millions,’ the source said.

The restrictions on fundraising and soliciting donations mean hospitals and clinics cannot explore alternative ways of obtaining urgently needed supplies while government procurement processes remain constrained.

Patients have to look elsewhere to obtain their prescriptions. The shortages also extend to basic wound-care materials, including cotton wool and bandages, placing additional pressure on patients who depend entirely on the public health system.

The revelation comes just days after President Duma Boko returned from a state visit to China where, he said, the government secured a commitment of medical equipment and healthcare consumables worth tens of millions.

Addressing the media in Gaborone on October 19, Boko announced that China had also deployed 46 doctors to assist, as the government seeks to address challenges in the health sector. He also referred to anticipated medicine supplies from Oman reportedly worth millions as well.

The medicine supply crisis previously prompted Boko to declare a public health emergency in August 2025 after severe shortages affected hospitals and clinics nationwide. The disruption included shortages of essential medicines and medical commodities, with the government launching emergency procurement and distribution interventions.

In January 2026, the Ministry of Health reported that medicine availability had improved through local and international procurement, while acknowledging that the supply situation had yet to stabilise fully.

The latest account from the health professional suggests that serious gaps persist, particularly in access to essential medicines and basic consumables.

Botswana is expected to finance its HIV and tuberculosis (TB) programmes entirely from domestic resources by the end of 2030. This is after the Global Fund to Fight AIDS, Tuberculosis and Malaria designated its latest grant cycle as the country’s final allocation for the two diseases.

The decision is accompanied by a reduction in funding for HIV with Botswana’s allocation falling from US$22.88 million (about P305.45 million) under Grant Cycle 7 (GC7) to US$13.12 million (about P175.15 million) under Grant Cycle 8 (GC8). This is a decline of 42.6% or approximately US$9.75 million (about P130.16 million).

The tuberculosis allocation has also been reduced from US$1.15 million (about P15.35 million) to US$979,998 (about P13.08 million). This represents a 14.4% decrease.

The funding decision places pressure on the government to develop a credible financing plan to sustain HIV prevention, treatment and community-based services, while maintaining TB diagnosis and treatment as the country prepares for the withdrawal of the Global Fund’s financial support.

In an allocation letter dated 13 March 2026 addressed to Botswana government representative, Thapelo Phuthego and currently the deputy permanent secretary in the Ministry of Youth and Gender Affairs, Head of the Global Fund’s Grant Management Division,Mark Eldon-Edington states that the latest funding cycle will be the last for both HIV and TB.

‘In line with the Global Fund’s Sustainability, Transition, and Co-Financing Policy (STC policy), the Global Fund has determined that GC8 will be the final allocation for Botswana for HIV and TB, so investment priorities should reflect the need to transition to domestic funding at the end of this grant cycle,’ Eldon-Edington states.

The grants are scheduled to cover the period from 1 January 2028 to 31 December 2030 giving Botswana a defined window to prepare for the transition.

The Global Fund has allocated Botswana up to US$14.10 million (about P188.30 million) for HIV, TB and resilient and sustainable health systems during GC8. Of this amount, US$13.12 million (about P175.15 million) is earmarked for HIV and US$979,998 (about P13.08 million) for TB.

The allocation letter makes clear that the challenge extends beyond replacing donor money. Botswana is expected to reform procurement, strengthen public financial management and integrate HIV and TB services into the broader healthcare system to ensure that programmes remain sustainable after external financing ends.

Eldon-Edington warns that the decision comes at a time when external health financing is constrained and the global health environment is changing rapidly.

Eldon-Edington adds that; ‘Together, the Global Fund partnership has made remarkable progress in the fight against HIV, tuberculosis (TB) and malaria over the past two decades.’

‘Now, with significant constraints in external financing for health and a rapidly evolving global health ecosystem, we must adapt and intensify our focus on delivering sustainable health outcomes in this new context,’ he says.

He says the new funding framework is intended to accelerate countries’ transition towards self-reliance, sharpen spending priorities and improve value for money.

‘For GC8, Botswana has been allocated up to US$14,104,603 (about P188.30 million) for HIV, TB and building resilient and sustainable systems for health (RSSH). This allocation has been determined according to a methodology primarily based on disease burden and income level,’ the letter states.

The Global Fund has urged Botswana to develop a robust transition plan aimed at fully domestically funded HIV and TB responses. It warns that investment decisions under the final grant cycle must take account of the impending withdrawal of its support.

‘Botswana is encouraged to focus on implementing a robust transition plan to enable fully domestically-funded HIV and TB responses,’ Eldon-Edington says.

He adds that the country should prioritise sustainable financing for community health systems, cost-effective procurement, integrating disease programmes into the wider health system and streamlining management structures.

The letter also urges Botswana to strengthen government-led financing for civil society organisations that provide HIV and TB services including expanding social contracting arrangements that allow such organisations to deliver essential services.

On HIV prevention, the Global Fund recommends prioritising integrated pre-exposure prophylaxis (PrEP), sexual and reproductive health services, and hepatitis services, particularly for vulnerable populations.

For TB, it recommends more efficient screening, integrated service delivery and near point-of-care molecular testing to improve diagnosis and increase case notifications.

The transition will also require the government to assume responsibility for health infrastructure and operating costs previously supported by the fund.

Eldon-Edington recommends further that; ‘Transitioning health systems investments financed by the Global Fund to domestic financing including support for PSA plants, GeneXpert maintenance and operational costs, and critical human resources supporting HIV and TB service delivery.’

Botswana athletes seeking to compete at the World Athletics Championships in 2027 are obligated to have undergone at least three out-of-competition testing in the 10-month period prior to 26 August 2027.

This is as per the order of the Athletics Integrity Unit (AIU) Board in a letter dated 14th October 2026 and emailed to the Botswana Athletics Association (BAA).

In the letter, which was signed by Head of the AIU Brett Clothier, the AIU warns that ‘no athlete may participate as part of the Botswana National Team in the 2027 World Athletics Championships’ unless they have undergone the stipulated out of competition tests.

‘The three no notice out-of-competition tests must have been conducted with at least 21 full days between each test. The first of the three no notice out-of-competition tests must have been conducted no later than 24 weeks prior to the start of the competition, namely by 26 March 2027,’ the AIU states in the letter.

According to the AIU, the decision to impose ‘specific testing obligations’ on BAA ‘was as a result of the BAA’s failure to meet its testing obligations for 2022, 2023 and 2024 pursuant to Rule 15.6.1.’

It further explains ‘the decision to impose specific testing obligations came after it had conducted a comprehensive review of the testing conducted on Category B Federation national teams following the 2025 Tokyo World Championships.’

From the said review, it was discovered that ‘the level of out-of-competition testing conducted on the Botswana team who competed at the Tokyo World Championships showed no material improvement in 2025. On the contrary, it showed that ‘the level of out-of-competition testing of Botswana athletes in the lead -up to Tokyo in fact decreased.’

Botswana ranked 19th in Tokyo and ‘had the highest percentage of top-ranked athletes in its team in Tokyo, with 5 of the 10 athletes in the Top 8.’

Of concern however for the AIU was that ‘only 8 out-of-competition tests were conducted by the Botswana NADO on athletes competing in Tokyo.’ It further discovered that ‘30% of the National Team competing in Tokyo,’ representing 3 athletes, ‘had not undergone any out-of-competition tests.’

Another cause for concern was the AIU’s discovery that ‘out -of -competition testing by the NADO in Botswana decreased in the lead -up to Tokyo (compared to the lead -up to Paris), despite the two AIU warning letters sent in early and late 2024.’ The review further discovered that ‘there was no national testing pool and no whereabouts programme in place.’

‘Pursuant to Rule 15.6.4, the AIU Board decided in the circumstances to impose the following testing obligations on the BAA for the purposes of the 2027 World Athletics Championships taking place in Beijing, China on 10-19 September 2027.

The testing obligations however will not affect Botswana’s elite athletes such as Letsile Tebogo, Collen Kebinatshipi, Bayapo Ndori and Tshepiso Masalela. The AIU Board in its letter stipulates that ‘the specific testing obligations relate to BAA athletes who are not part of the International Registered Testing Pool.’

The quartet, which forms the core of Botswana’s elite team and also regarded as among the best in the world, are in the AIU’s international Registered Pool. Unlike the rest of the athletes, these athletes are subjected to a very strict and rigorous testing regime by the AIU both in and out of competition.

As a privilege of being among the elite, they are expected to inform the AIU about their exact location every single day of the year through the Anti-Doping Administration and Management System (ADAMS). They are also required without fail to provide a specific 60-minute time slot everyday where they guarantee their availability for testing. The intrusive testing system means they have to, among others, log in details of where they will spend their nights each single day, where they will train as well as their competition schedules.

The imposition of the strict out-of-competition testing for local athletes, has been welcomed by the BAA. ‘We welcome the AIU decision. As an association, we are advocates for clean sport. We want our athletes to compete fairly and not cheat. People have to earn their stripes,’ BAA president Oabona Theetso says.

He adds that the letter in no way implies that Botswana athletes are doping. Rather, it seeks to ensure strict adherence to testing. ‘Our athletes were tested prior to competitions, more especially during camps. What the AIU seeks is for us to increase the frequency of testing as the tests were carried out were not enough.’

Theetso went on to emphasise that the testing was meant for athletes who were not yet in the top tier of elites in the world. ‘As you know, four of our top elites, Letsile, Kebinatshipi, Ndori and Masalela are in the international registered testing pool and are tested by the AIU. These athletes are not affected by the AIU directive.’

He says the BAA will continue to work around the clock to ensure local athletes meet the AIU requirements and are eligible to compete.

When it comes to their relationship with De Beers, President Duma Boko and his predecessor Mokgweetsi Masisi are serving pure ‘frenemy energy.’

In Botswana’s plugged-in political circles, polite company knows better than to drop De Beers’ name around the two adversaries without risking an immediate, icy shift in the room.

Yet, when the wire transfer cleared last week, crediting the newly minted Diamond for Development Fund with one billion Pula (USD 73 million), a rare moment of shared satisfaction echoed across Botswana’s political divide. Both Boko and Masisi had reason to smile. The former president, watching his fiercely defended vision finally come to life, and the current president watching a massive financial asset land securely on his watch without a single political casualty.

It was more than just a massive financial windfall for Botswana’s diamond-dependent economy, it was a masterclass in the quiet mechanics of statecraft.

Behind the historic transaction’s standard bureaucratic handshakes and corporate press releases lies a remarkably human story of two political adversaries inadvertently working in tandem. Masisi drew the bold, nationalistic blueprint in 2023, aggressively rewriting the rules of engagement with De Beers to ensure local resources benefited local people. Three years later, it was President Boko who took the baton, infusing the process with reassuring diplomacy that turned a fiery political promise into last week’s cold, hard cash.

For President Boko, the moment was also a highly personal, resounding victory over a narrative of impending crisis. Inheriting a complex, unfinished diamond pact from his bitter political rival, whose fiery, nationalistic rhetoric had pushed negotiations with De Beers to the absolute brink, could have easily led to legislative gridlock or international investor panic.

Many wondered if Boko would tear up Masisi’s hard-fought blueprint out of political spite, or if De Beers would use the transition to claw back concessions. Instead, by smoothly facilitating the rollout of the fund and welcoming the board to Gaborone, Boko didn’t just preserve the peace, he co-opted his predecessor’s crowning achievement.

For a global audience watching Botswana’s historic democratic transition, this seamless handoff of a multi-billion-pula corporate deal proved that while political regimes may change, the bedrock of Botswana’s economic stability remains entirely unshakeable. Boko signaled to nervous international markets that while Botswana’s leadership had changed, its status as a sanctuary of democratic stability, predictable governance, and safe foreign investment remained completely untouchable.

De Beers’ last week’s historic payout of the first USD 73 million was not a sudden act of corporate charity. Far from it. The windfall was forged in the blistering political theater of 2023, a direct dividend of a grueling negotiation process that pushed the boundaries of public statecraft. That was the year the global mining sector sat stunned by the fierce, unapologetic stance of then-President Masisi, who repeatedly pushed the nation’s foundational partnership to the absolute edge. The global mining sector was stunned. For more than half a century, the partnership between Botswana government and De Beers through their joint venture, Debswana, had been conducted in hushed tones behind closed boardroom doors.

Masisi tore up that traditional playbook. Taking his message directly to public rallies across the country, he passionately argued that the status quo was no longer enough. He insisted that Botswana deserved more than the ‘crumbs’ of its own natural wealth, boldly threatening to walk away from the partnership if a radically overhauled sales agreement could not be reached.

It was a high-risk gamble that captured the imagination of the nation. By mid-2023, Masisi’s relentless pressure had achieved the unthinkable, an agreement-in-principle that would progressively scale up the state-owned Okavango Diamond Company’s (ODC) share of rough diamond allocations from 25% to an unprecedented 50% over a decade. Crucially, De Beers also committed to anchoring a brand-new economic diversification vehicle-pledging BWP 10 billion over ten years, starting with a first-year injection of BWP 1 billion.

Yet, as the nation prepared for the historic 2024 general elections, the final, legally binding fine print remained incomplete. The blueprint was drawn, but the actual pipeline to move the money from London to Gaborone had not yet been built.

When Boko and the Umbrella for Democratic Change (UDC) coalition won the October 2024 elections, it marked the first time since independence in 1966 that the ruling party had changed hands. In many resource-rich corners of the globe, a political transition of this magnitude spells immediate danger for existing mega-contracts. Newly elected governments frequently succumb to the temptation of canceling their predecessors’ flagship initiatives to score easy political points or stamp their own name on the national narrative.

Botswana, however, chose a path of institutional grace. Upon stepping into the Office of the President, Boko was immediately confronted with an economic headwind. The global natural diamond market was enduring a cyclical downturn, squeezed by macroeconomic pressures and the rapid rise of lab-grown alternatives. Debswana’s sales were dropping, and the national treasury required swift, decisive action.

Recognizing that Masisi’s public brinkmanship had already served its purpose by locking in De Beers’ commitments, Boko executed a brilliant tactical shift. He pivoted from public ultimatums to corporate diplomacy. Boko spoke eloquently of ‘civility, maturity, and sensitivity’ as the new guiding lights for foreign investment. By honoring the structural integrity of the 2023 framework, Boko sent a booming signal of confidence to international markets, that in Botswana, a sovereign promise survives the ballot box.

If the fund was a radical idea, its execution demanded an ironclad guarantee of institutional transparency. Boko and De Beers’ Al Cook bound themselves to a strict, self-imposed covenant, that not a single thebe would cross the ledger until the fund’s governance architecture was entirely bulletproof.

The breakthrough came at the JCK Las Vegas industry showcase earlier this year, where Dr. Akinwumi Adesina, the widely respected former president of the African Development Bank, was named chairperson. Adesina brought immediate, heavyweight global credibility to the vehicle. Over the subsequent months, a vetting process assembled a 10-member independent board composed of international financial experts, legal minds, and industry titans.

This deliberate delay sparked intense debate within Botswana. As the diamond slump deepened and cash reserves tightened, some argued that holding back the initial P1 billion contribution was disadvantaging a country in desperate need of an economic cushion.

But from an institutional perspective, the delay was a defensive necessity. Releasing a billion pula into a vacuum without oversight mechanisms would have invited bureaucratic inertia or misallocation. By waiting until the board was fully seated and operational in Gaborone-culminating in their meeting with President Boko, the partners ensured the fund possessed the legal and structural credibility required to achieve its ultimate goal, comforting international markets and attracting much larger pools of private, third-party global capital

With the first BWP 1 billion now officially secured in the fund’s accounts, the focus shifts to the tangible, feel-good transformations unfolding across the country. Unlike traditional mining revenues that simply filter into general budgetary support, this fund is strictly designated as ‘catalytic seed capital’ for sectors entirely divorced from diamonds.

Already, the blueprint for the fund’s first deployment is generating palpable excitement. In the sun-drenched fields of the Kgalagadi, plans are accelerating for large-scale solar energy grids aimed at positioning Botswana as a net exporter of clean electricity. In agricultural hubs like Pandamatenga, the capital is being earmarked to fund smart-farming technologies and climate-resilient irrigation, directly tackling food security. Meanwhile, in urban centers like Gaborone and Francistown, young Motswana innovators are looking forward to venture capital pools intended to supercharge the local digital economy and create the sustainable tech jobs of tomorrow. By targeting these specific, forward-looking industries, the fund is effectively doing what economists have urged for decades, using a finite underground resource to build an infinite above-ground economy.

Botswana faces the risk of further cuts to international HIV and tuberculosis funding if it fails to demonstrate that previous government financing commitments were fulfilled. The Global Fund has also warned that it could reduce funding by twice the outstanding recoverable amount if the debt is not satisfactorily repaid.

The warning is contained in an annexture accompanying a letter addressed to government representative Thapelo Phuthego who is currently the Deputy Permanent Secretary in the Ministry of Youth and Gender Affairs. The letter was from Head of the Grant Management Division at the Global Fund to Fight AIDS, Tuberculosis and Malaria, Mark Eldon-Edington.

The document sets out conditions governing Botswana’s next funding cycle, including requirements to account for previous commitments, increase domestic spending and prepare for the eventual withdrawal of external support.

The Global Fund warns that failure to realise previous co-financing commitments under its seventh grant cycle could result in reductions to existing grants and/or Botswana’s next allocation.

‘Failure to realize previous co-financing commitments from GC7 may result in the Global Fund reducing funds from existing grants and/or the GC8 allocation,’ the annexure states.

Botswana is required to submit evidence that previous commitments were fulfilled when applying for the next funding cycle. This includes proof of expenditure on increased government health spending, disease programmes and specific programme-related activities.

The conditions place the government under pressure to demonstrate that promised domestic resources translated into actual spending as it prepares to assume greater responsibility for financing the national HIV and TB response.

The annexure also reveals that Botswana had an outstanding recoverable amount of US$297,414 (approximately P4.23 million) owed to the Global Fund as of February 15, 2026. Of that amount, US$96,882 (approximately P1.38 million) was overdue under the relevant grant agreements.

The document warns that failure to repay the money satisfactorily could trigger remedial action, including a funding reduction equivalent to twice the outstanding recoverable amount.

That could expose Botswana to a potential reduction of US$594,828 (approximately P8.46 million), if the Global Fund applies the specified measure to the full outstanding balance. The debt is separate from the new domestic investment requirements attached to the next allocation.

Under the eighth grant cycle, known as GC8, Botswana must commit at least US$4,231,381 (approximately P60.2 million) in additional domestic investment to qualify for its full allocation.

The Global Fund states that 25 percent of Botswana’s allocation is conditional on meeting co-financing requirements.

As an upper-middle-income country, Botswana must direct all its co-financing commitments towards specified sustainability and transition activities, with particular attention to key and vulnerable populations.

The funding should support essential services that will need to continue after the Global Fund’s financial support ends. These include healthcare personnel, data systems for monitoring HIV and TB, and community and civil society organisations that help vulnerable groups access services.

The annexure also calls for continued procurement reforms to improve efficiency and ensure essential health products remain affordable and accessible. The government must provide a formal co-financing commitment letter and subsequently supply evidence from appropriate authorities, including the Ministry of Finance, demonstrating that the commitments have been realised.

The document makes clear that the next allocation is intended to support Botswana’s transition towards financing its HIV and TB programmes increasingly from domestic resources.

The new grant is scheduled to begin on January 1, 2028. Botswana is being asked to use a tailored funding application approach designed for countries transitioning from external assistance.

The Global Fund requires applications for eligible disease components to be submitted together and, where feasible, integrated into a single funding request. A joint HIV and TB application is mandatory because of the high level of co-infection.

Botswana is also encouraged to have a principal recipient in place when submitting its application, with sub-recipients and implementing partners identified before the grant is signed.

The document warns that the allocation is based on announced donor pledges and that some funding may not materialise if donor contributions fall short. In that event, the Global Fund, government and implementing partners would have to adjust programme designs to accommodate the reductions.

A quiet mutiny is brewing within the ruling Umbrella for Democratic Change (UDC), as backbench Members of Parliament aggressively organize to demand substantial salary and allowance hikes. Citing Botswana’s sharp economic rebound in 2026, legislators are preparing to submit a formal proposal to Vice President and Minister of Finance Ndaba Gaolathe ahead of the November Parliament sitting and President Duma Boko’s State of the Nation Address (SONA).

However, the move is expected to ignite widespread public anger, exposing deep hypocrisies within the ruling coalition. When the UDC won its historic election victory in late 2024, ending nearly six decades of BDP rule, its cornerstone promise was sweeping fiscal austerity. President Duma Boko and Vice president Ndaba Gaolathe declared that the previous government had left the state purse empty, even floating a mandatory 12-month salary cut for politicians to address the crisis. Now, just two years into their term, their own backbenchers are demanding the opposite.

The MPs argue that their financial restraint is no longer required given the Central Bank’s glowing economic indicators. Backbenchers are weaponizing Botswana’s 8.7% Q2 2026 GDP expansion-driven by a temporary volume surge in diamond mining-to prove the state can afford a pay raise.

The Bank of Botswana External Statistics Bulletin revealed a 20% surge in foreign exchange reserves, rising from P46.3 billion in Q1 2025 to P55.9 billion in Q2 2026, buoyed by stronger diamond royalties and Southern African Customs Union (SACU) receipts.

The push coincides with Minister Gaolathe’s confirmation that the Government Investment Account recovered by over 200%, rising from a critically low P2 billion in 2024 to P6 billion in mid-2026. MPs argue this newfound cushion should extend to them.

The optics of politicians demanding higher wages is expected to touch off public outrage and a fierce pushback from trade unions. Public workers are currently suffocating under a massive cost-of-living crisis. Labor bodies like the Manual Workers Union and BOFEPUSU are heavily pressuring the UDC to fix inherited civil service wage structures and deliver on pre-election promises before touching political compensation.

The UDC campaigned heavily on establishing a P4,000 monthly living wage, an P1,800 old-age pension, and scaling the Ipelegeng wage to P2,500. Political commentators note that rewarding politicians while these flagship social targets remain unlegislated could spell electoral doom for the party.

Public trust has already been strained by reports that the ‘broke’ government quietly allowed increases to parliamentary perks, including a P1.2 million luxury furniture allowance for ministers, while ordinary citizens saw no relief.

The proposed wage hike faces immediate resistance from the executive branch, which is trying to prevent a full-blown political crisis. Parliamentary Chief Whip Sam Digwa told Sunday Standard that he has not received the MPs demands. He however attempted to stall the proposal, reminding rebellious MPs that the country’s recovery is highly fragile and structurally dependent on a volatile diamond market.

‘It is a highly sensitive issue,’ Digwa cautioned, urging MPs to remain patient.

To override the cabinet’s hesitation, UDC backbenchers are crossing the aisle to form an alliance with the opposition Botswana Congress Party (BCP) to build a unified legislative majority capable of forcing the executive’s hand.

The battle also revives local tensions regarding political perks. The last salary adjustment in December 2023 under former President Mokgweetsi Masisi granted a controversial P19,000 monthly constituency allowance explicitly for the President. The UDC vehemently opposed the perk while in opposition, but with their own backbenchers now eager to expand their pockets, the coalition’s commitment to dismantling BDP-era political luxuries is facing its ultimate test.