When we talk about health financing in Africa, the conversation often centres on external funding. While international investment plays a significant role, there are powerful examples of how African nations are mobilising domestic resources to build sustainable health systems.

Take the Republic of Botswana for example:

Through a strategic public-private partnership, Debswana Diamond Company- a joint venture between the Government of Botswana and De Beers Group, has reinvested diamond wealth into healthcare. With over approx. USD 11 600 000 allocated annually to run district referral hospitals, Debswana ensures that 80% of the patients served are members of the public, at no extra cost.

What makes this model innovative?

• Public-private collaboration: The government and private sector co-invest in health infrastructure.
• Universal access: The hospitals are open to all, not just employees.
• Long-term vision: Contributions align with Botswana’s Vision 2036 and the UN SDGs, ensuring sustainability.

Beyond hospital management, Debswana’s commitment extends to HIV and TB outreach, maternal health services, and even e-pharmacy innovations to improve medication access. Their response to COVID-19 alone saw approx. USD 16 430 000.00 in contributions, highlighting how domestic resources can be rapidly mobilised in times of crisis.

In December 2021, Botswana became the first high HIV burden country to be certified by the WHO Global Validation Advisory Committee (GVAC) as having achieved a critical milestone along the path to eliminating vertical HIV transmission. UNAIDS data shows that over 95% of pregnant women in Botswana were receiving antiretroviral therapy in 2021, up from 77% in 2010. Vertical transmission rates were only 2.2%, down from 9.0% a decade earlier.

Botswana’s approach demonstrates that African nations have the potential to lead and sustain their national health financing through innovative funding mechanisms, strategic partnerships, and long-term planning. This is the kind of homegrown solution that can be replicated across the continent.