Medicine Crisis Explodes at PAC

A fiery Public Accounts Committee hearing further unraveled Botswana’s medicine crisis as MPs, health officials and Central Medical Stores traded blame over shortages, expired drugs and a growing public demand for accountability. Botswana’s long-running medicine crisis erupted in dramatic fashion before Parliament’s Public Accounts Committee (PAC) on Wednesday, with explosive exchanges exposing some of the officials at the centre of the country’s troubled pharmaceutical supply chain while offering little clarity on who will ultimately take responsibility for persistent medicine shortages. The hearing quickly descended into a heated confrontation as Lobatse MP Kamal Jacobs launched a blistering attack on Acting Director of Botswana’s Central Medical Stores (CMS), Dr Bene Paramadhas, accusing him of incompetence and threatening to seek his deportation.

Jacobs said patients were paying with their lives, saying every Motswana should be able to access the medicines they need and that people were dying because of medicine shortages. He added that in Lobatse alone he buries five or six people every week whose deaths he believes are linked to the unavailability of essential medicines. The confrontation came after Ministry of Health officials confirmed that medicines worth more than P95 million had expired while under government care despite continuing shortages across the country’s health facilities.

Acting Permanent Secretary Dr Tshepo Machacha told the committee that procurement functions remained heavily under-capacitated, forcing repeated emergency procurement, direct appointments and retrospective approvals rather than strategic purchasing. Machacha also argued that Botswana’s greatest health challenge was the growing burden of non-communicable diseases, saying the country faced what amounted to a pandemic of lifestyle-related illnesses. He suggested that medication alone would not solve Botswana’s healthcare challenges and that improving public health would also require healthier lifestyle choices by citizens.

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The remarks shifted part of the discussion away from medicine availability and onto patient behaviour, a position likely to fuel further public debate given the continuing shortages experienced across public health facilities. For many observers, the hearing offered an unprecedented glimpse into the officials responsible for Botswana’s medicine supply chain while revealing how fragmented accountability has become. What emerged was a health system struggling not only to keep medicines on pharmacy shelves, but also to convince the public that anyone is ultimately accountable when those medicines fail to arrive.

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