News

The future of Botswana’s health system came under the spotlight last week as doctors, policymakers and international health experts gathered for the 2025 Botswana Family Medicine and Primary Health Care Symposium. Under the theme “Primary Care Financing - Money Matters in Primary Care,” the symposium, hosted by the Botswana Association of Family Physicians, zeroed in on a pressing concern: how the nation can sustainably fund primary health care in the face of growing fiscal pressures.

Welcoming the delegates, University of Botswana (UB) Vice Chancellor, Professor David Norris, underscored the transformative power of interdisciplinary innovation. Professor Norris emphasised the role of technology-driven initiatives in extending care to underserved populations remotely, noting that such innovations could reduce costs for government. He stressed that universities must take the lead in driving these solutions.

The World Health Organisation (WHO) representative to Botswana, Dr Fabian Ndenzako, framed primary health care financing not merely as a budgetary concern but as a strategic, moral and political imperative. Dr Ndenzako added that Botswana was lauded for consistently dedicating over five (5) percent of its GDP to health, noting it as a rare achievement on the continent. However, he warned that sustainable financing must go beyond numbers, requiring equitable resource distribution, resilient systems and people-centred payment mechanisms.

For her part, Permanent Secretary in the Ministry of Health, Professor Oathokwa Nkomazana, indicated that despite historical strength in primary care, the system had drifted towards curative services, a shift accelerated by the then HIV crisis.

“We do not have money for prevention. We do not have money for health promotion,” Prof Nkomazana admitted, noting that 80 to 90 percent of the health budget was consumed by treatment. The imbalance, she argued, threatened the affordability and sustainability of the entire system.

Moreover, Professor Nkomazana mentioned that efforts to recalibrate were underway through the Botswana Economic Transformation Programme (BETP) health lab, with primary care been positioned as the central driver of reform.

The symposium boasted an array of health professionals in thought provoking discussions that did not shy away from complexity. Speakers acknowledged that turning around entrenched systems required persistence, political will and an entire government approach.