By Kemo Cham
Health Alert, one of Sierra Leone’s leading healthcare campaign groups, has launched an advocacy campaign geared towards ensuring increased domestic healthcare financing.
Dubbed: ‘Advocacy for increased finance and immunization for primary healthcare,’ the project is co-implemented by WASH Net Sierra Leone, in partnership with the Global Health Advocacy Incubator (GHAI) and the Global Alliance for Vaccine and Immunization (GAVI). The initiative aims to advocate for increased domestic resource mobilization to strengthen immunization finance and primary healthcare in the country.
The campaign was launched at an event in the conference hall of the Freetown City Council on Wednesday, 19th March, 2025, bringing together key stakeholders from government, its development partners, civil society organizations, and community representatives.
Victor Lansana Koroma, Executive Director of Health Alert, while giving an overview of the project, said it was designed to foster collaboration and drive sustainable solutions in the healthcare sector.
The initiative comes amid growing calls for a rethink by developing countries like Sierra Leone which heavily depend on donor funding for their development. This has become even more pertinent with the changing dynamics in international aid occasioned by the administration of US President Donald Trump’s restriction of funding for international aid.
The US’ chief international development arm, USAID is a major funder of development initiatives in Sierra Leone, particularly in the health sector. A lot of these activities have been shrouded in uncertainty since the agency’s operations were restricted amid discussions about its faith.
Health authorities and campaigners fear for the impact of this on Sierra Leone’s immunization programme, which is the single largest intervention in its healthcare sector.
According to an analysis of the financial gaps and resources required to support immunization and primary healthcare, Sierra Leone remains a high donor dependent nation for health financing for both primary healthcare and immunization. Data from the study show that prioritization of immunization has occasioned an increased demand for funding over the years.
The global vaccine alliance, GAVI has been one of the top donors towards immunization in the country. Nonetheless, as revealed in the financial analysis presented by local consultant Nathaniel Suluku, health financing remains very low on the basis of international standards – notably the African Union’s target of 15 percent health care spending and the global target of 5 percent GDP spending on health care.
The data further shows that while budget allocation to healthcare has increased over the last five years in Sierra Leone, it is still insufficient. Consequently, Sierra Leone has a very high out of pocket spending on healthcare – 50.4 percent – according to the National Health Account study of 2021, the latest such data.
In the last five years, allocations to the health sector has fluctuated between 7 percent in 2020 and the highest at 11 percent in 2022. As of 2025, allocation to the health sector stands at 9 percent.
Domestic funding on vaccine administration between 2017 and 2021 has been below 14 percent, according to the data.
This, warn campaigners, threatens the country’s prospect of attaining Universal Health Coverage, in line with the United Nations Sustainable Development Goals.
Sierra Leone is one of 10 countries in African supported in the GAVI-GHAI initiative to lead advocacy efforts to increase domestic financing for immunization.
Jonas Mbwangue, Associated Director of Immunization at GHAI based in Washington DC., said they are partnering with local stakeholders to serve as champions for immunization.
“One of our objectives is to build political commitment in mobilizing domestic resources in the country to finance Primary health care and immunization,” he stated.
But allocation is one thing and execution or actual disbursement of funds is an altogether different thing, which campaigners say has been a huge issue over the years, seriously affecting financing for the primary healthcare in Sierra Leone.
Through this nine-month long programme, Health Alert and its partners intend to change all of this through engaging key stakeholders.
Wednesday’s launch took the form of interactive sessions, including a panel discussion bringing together representatives of relevant stakeholders, including an immunization expert from UNICEF, the Manager for the Expanded Programme on Immunization, a Budget Expert from the Ministry of Finance, a representative of the Parliamentary Committee on Health, as well as District Medical Officers and Local Council representatives from five districts targeted by the project. They discussed issues determining budget allocations and possible ways of improving on them.
The panel also discussed implementation, sustainability, and innovative strategies that will promote revenue mobilisation for immunization and possible drafting of a bill to support the allocation of a separate budget for immunization.
