President Duma Boko has acknowledged the urgent need to overhaul Botswana’s health systems, citing inefficiencies and delayed responsiveness that continue to cost lives. He was speaking during a high-level engagement with Dr. Matshidiso Moeti, former WHO Regional Director for Africa, who was accompanied by the WHO Representative to Botswana, Dr. Fabian Ndenzako and other officers from the WHO country office.
With visible respect for Dr. Moeti’s global health leadership, President Boko expressed his appreciation for the opportunity to engage in a candid and solutions-focused dialogue. “Your wisdom and guidance are not only welcome, they are needed,” he told her warmly.President Boko spoke candidly about the reality facing Botswana’s health sector. “Botswana is wrestling with serious challenges, basic issues of access, shortages in essential and chronic medications, and growing public frustration,” he said. He acknowledged that the burden of public expectation weighed heavily on his administration, adding, “One of government’s biggest problems is government itself.”
He described entrenched inefficiencies, sluggish processes, and systemic wastage as serious barriers to progress, particularly in healthcare, where dysfunction often leads to loss of life. “It would be insensitive to ignore the palpable tragedy this creates,” he said. The President stressed that access to healthcare must also mean access to quality healthcare. “We must not pride ourselves in universal access to low-quality services. That is not progress,” he noted. He called for a fundamental rethink of how healthcare is delivered and governed.
A major part of that rethink, both he and Dr. Moeti agreed, involves stronger health information systems. “If your data reaches you a year later, it delays the interventions you need to make,” the President said. Dr. Moeti echoed this view, stressing that robust, near real-time data systems are essential for transparency, effectiveness, and agility. “Using data to inform what’s happening, what’s working, and what’s not, that is the only way to strengthen system performance,” she said.
Procurement was another area of deep concern. President Boko spoke bluntly about manipulation, litigation, and delays in the current system. “I am averse, hostile even, to the current procurement mechanisms,” he said, citing the African Union’s failure to deploy $250 million in COVID-19 response funds as an example of how excessive bureaucracy can cost lives. To bridge current gaps, Dr. Moeti proposed leveraging global procurement mechanisms, such as those used by UNICEF, to ensure Botswana can access essential medicines while reforming its own systems. “These partnerships can offer practical, economical solutions in the interim,” she noted.
The meeting marked a clear alignment between Botswana’s leadership and WHO on the urgent need for reform, grounded in transparency, evidence, and collaboration. As President Boko concluded, “The way we’ve been doing things has not worked. Now is the time to fix what’s broken and WHO can help us do that.”
