The Botswana Nurses Union (BONU) has urged the Umbrella for Democratic Change government to prioritise healthcare, warning that the sector is overburdened after years of neglect and systemic failures.
Responding to the President’s State of the Nation Address, the nurses’ advocacy body said persistent underinvestment has eroded public confidence in the country’s health system.
BONU called on the government to make “urgent and sustained investment” in healthcare to address deteriorating infrastructure, inconsistent medical supply chains, inadequate postgraduate nursing training and limited stakeholder consultation on major reforms.
The Union expressed deep concern that health facilities across the country remain in a severe state of disrepair despite mounting pressure on the public system. Nurses, BONU said, cannot provide safe, quality care in environments with broken equipment, cracked infrastructure, unreliable water systems and poor sanitation. Such conditions place both patients and healthcare workers at risk and compromise the quality of care.
The Union urged the government to fast-track a national rehabilitation programme, warning that the success of wider reforms, including the proposed National Health Insurance (NHI), depends on safe, functional and modern hospitals and clinics.
BONU also drew attention to the fragility of the medical supply chain, noting that Botswana only recently emerged from a near-total collapse of essential medicines and commodities. While the Union welcomed the government’s emergency procurement of more than P500 million worth of medical supplies, it stressed that long-term sustainability, not crisis-driven responses, must guide reforms.
According to BONU, stabilising the supply chain will require structural changes, including better inventory management, stronger accountability mechanisms and consistent funding for essential medicines and equipment.
On the proposed NHI scheme, BONU reiterated its concerns about inadequate stakeholder engagement. While supporting the principle of equitable healthcare financing, the Union warned that insufficient consultation with frontline workers—who will be central to the rollout—could jeopardise implementation. Nurses, BONU said, need clearly defined roles, proper training and representation on planning committees to ensure the scheme succeeds once implemented nationally.
While BONU’s concerns highlight critical weaknesses in the system, government maintains that significant steps are already underway to stabilise and reform the sector.
The government agrees that many health facilities are ageing and dysfunctional. It says it will use the Health First Botswana Partnership to prioritise upgrades and has secured a P700 million grant for primary healthcare infrastructure improvements, health promotion, early detection and treatment services.
Additional investments include new radiology and laboratory equipment, such as two new X-ray machines for Princess Marina Hospital and three mobile X-ray units for Gumare, Gweta and Bobonong.
Government also says progress is being made on the NHI, with ongoing consultations involving academics, policymakers and community groups. Officials insist the final policy will reflect national input and will be published for public comment before implementation.
Following last year’s supply chain collapse, government declared a State of Public Health Emergency in August 2025. Since then, the Central Medical Stores has been undergoing a full restructuring.

Original source: bw