Botswana is facing a renewed HIV crisis as widespread shortages of condoms, HIV test kits, and essential sexually transmitted infection (STI) medications grip the country, threatening to reverse decades of progress in the fight against HIV/AIDS.
The Botswana Network on Ethics, Law and HIV/AIDS (BONELA) has warned of what it calls systemic failures in the public health supply chain across multiple districts including Gaborone, Mahalapye, Palapye, Okavango, South East, Kgatleng, Francistown, and Kweneng.
This public health emergency unfolds against the backdrop of President Duma Boko’s August 2025 declaration of a national medical crisis. The president invoked emergency powers following a collapse in the country’s central medical supply system, which left hospitals and clinics critically short of medicines and basic supplies. In response, the government suspended non-urgent surgeries and allocated BWP 250 million for emergency procurement, with military oversight of distribution efforts.
Despite these measures, BONELA warns that the current shortages of HIV prevention commodities are not isolated incidents but indicative of deeper structural issues. “Access to condoms, HIV testing, and STI treatment is central to Botswana’s national HIV response,” BONELA stated. “Interruptions in these services jeopardize the health and rights of vulnerable populations, especially youth, women, and those in rural areas.”
Despite these measures, BONELA warns that the current shortages of HIV prevention commodities are not isolated incidents but indicative of deeper structural issues.
The implications are dire. Without condoms and test kits, communities are left exposed to increased HIV transmission, untreated STIs, and unintended pregnancies. The lack of early detection tools also hampers timely treatment, exacerbating health inequities and undermining Botswana’s commitment to ending AIDS as a public health threat by 2030.
BONELA has called on the Ministry of Health and the National AIDS and Health Promotion Agency (NAHPA) to take urgent action. Their recommendations include:
- Prioritising the procurement and equitable distribution of condoms, lubricants, HIV test kits, and STI medications.
- Strengthening national and district-level supply chain systems to prevent future stock-outs.
- Enhancing transparency in forecasting, monitoring, and reporting of commodity stocks.
- Improving coordination between government, civil society, and development partners to ensure sustained commodity security.
“Commodity security is a human rights and public health obligation,” BONELA emphasized. “Every interruption risks lives, health, and national progress.”
The crisis has also prompted calls for short-term, multi-sectoral solutions. BONELA suggests that the government explore partnerships with private sector providers to temporarily subsidise access to condoms and test kits. Community-based organisations (CBOs) could help redistribute available stock from well-supplied areas to underserved districts. Meanwhile, local leaders and youth networks are urged to continue promoting safe sexual practices and disseminating information about where limited supplies remain available.
President Boko’s emergency declaration was initially prompted by shortages of chronic disease medications and basic hospital supplies, but the HIV-related stock-outs now represent a critical escalation. International partners, including the United Arab Emirates, have responded with emergency aid shipments, yet the situation remains precarious.
Botswana has long been hailed as a regional leader in HIV prevention and treatment, with robust public health campaigns and widespread access to antiretroviral therapy. However, BONELA warns that these achievements are at risk if supply chain failures persist.
“The public’s confidence in the health system is eroding,” BONELA noted. “We must act decisively to restore access to life-saving commodities and protect the gains we’ve made.”
