In a bold move to safeguard its healthcare system against dwindling foreign aid, Botswana has launched a national health financing study aimed at ensuring sustainable domestic investment in healthcare and HIV and AIDS programmes.

Spearheaded by the Ministry of Health and the National AIDS and Health Promotion Agency (NAHPA), in collaboration with the World Health Organisation (WHO) and UNAIDS, the study will run from 1 June to 31 August 2025. Officially titled the Harmonised System of Health Accounts and National AIDS Spending Assessment, the initiative is seen as a critical step toward self-reliance in healthcare funding.

“This process is essential for policy decision making, ensuring efficient resource allocation, enhancing budget planning, progress towards the National Strategy Framework for HIV and AIDS, and advancing progress towards universal health coverage,” the Ministry and NAHPA said in a joint statement.

The study comes at a pivotal time. As international donors scale back contributions, Botswana, home to one of the world’s highest HIV prevalence rates, with approximately 21 percent of adults living with the virus, is facing growing pressure to fund essential services from domestic sources.

While the country has made notable gains in reducing new HIV infections and expanding access to antiretroviral therapy, the cost of maintaining these advances is steep. HIV and AIDS programmes alone consume a significant share of the national health budget.

To build a clear financial picture and inform future policy, the study will involve a wide spectrum of stakeholders, including government agencies, development partners, private medical aid providers, and NGOs. The data collected will help develop evidence-based strategies to improve efficiency, sustainability, and equity in health spending.

Policymakers hope the findings will chart a path toward resilient healthcare systems that can withstand funding shocks and deliver quality care regardless of global aid trends.