By Foday Moriba Conteh
The Executive Director of Health Alert Sierra Leone, Victor Lansanah Koroma, has on Monday 20th October, 2025 during a strategic stakeholder engagement with local councils at the organization’s head office on Blackhall Road in Freetown urged Local Councils and Civil Society Organizations (CSOs) across Sierra Leone to take stronger ownership of health financing and ensure that immunization and primary healthcare are prioritized in their annual budgets, as international donor support continues to decline.
The meeting, organized in partnership with WASH-Net Sierra Leone under the GAVI-Global Health Advocacy Incubator (GHAI) support framework, brought together representatives from district councils, partner CSOs and the media. It formed part of a broader review of how district councils are implementing commitments made during national and local budget consultations to strengthen healthcare delivery.
Victor Lansanah Koroma explained that the review aimed to assess whether councils had translated their earlier promises into tangible allocations for immunization and primary healthcare within their 2026 fiscal plans.
“This engagement is between Civil Society and Local Councils,” Victor Lansanah Koroma said. “We supported over ten CSOs nationally and several others across five districts to participate in the budget discussions. We now want to see whether those commitments to prioritize immunization and healthcare were actually implemented.”
He emphasized the importance of accountability and transparency, calling on finance officers from district councils to provide honest feedback on specific budget lines capturing immunization and primary healthcare.
“No child should die because they lack access to vaccines and no mother should lose her baby due to the absence of basic healthcare,” he added.
According to Victor Lansanah Koroma, findings from the five participating districts Kenema, Falaba, Bombali, Karene and Western Area Rural will be compiled into a policy brief to be shared with the Ministries of Health and Finance, as well as the Expanded Programme on Immunization (EPI), to guide national advocacy and planning.
However, the meeting came against the backdrop of sobering news: GAVI, the Global Vaccine Alliance, recently announced a 40 percent reduction in financial assistance to Sierra Leone, citing global funding constraints.
“If GAVI was giving ten million dollars before that support may now drop to just one or two million,” Victor Lansanah Koroma revealed. “Countries like Sierra Leone must now take ownership of their immunization programmes. Donor support is shrinking and councils must start owning the process of financing health and development.”
He expressed concern that Sierra Leone continues to politicize development efforts at a time when global donor assistance is diminishing.
“The world is changing. IMF, World Bank, GAVI and Global Fund are all cutting support. Yet we keep pretending everything is fine when it’s not. By now, this country should be discussing how to sustain development in the absence of donor funding,” he said.
Victor Lansanah Koroma also raised issues around budget transparency and accountability at the local Government level, questioning the practice of presenting multi-billion-Leone budgets without proper expenditure reports.
“You cannot present a budget of over thirty billion Leones for a whole year and have no clear report on how it was used, then call for a supplementary budget. Supplementary budgets are meant to add to existing efforts, not to replace accountability,” he stated.
He called for an honest national dialogue on how Sierra Leone can sustain development without excessive dependence on foreign aid, urging both local and national leaders to take greater responsibility for financing public services.
“The truth is donors are cutting back. If we do not start holding our leaders accountable and taking responsibility, we are heading for a serious crisis. It’s time to move from grammar to action,” he concluded.
During presentations from district representatives, several challenges were highlighted. In Karene District, Coordinator Samuel A. M. Sesay reported that immunization coverage remains around 60 percent due to vaccine stockouts, poor road access and inadequate logistics. He mentioned a new cold chain facility capable of storing 5,000 doses in Kamakanku, but said its remote location limits accessibility.
In Falaba District, Coordinator Issa Manty Kamara disclosed that the District Health Management Team (DHMT) lacks a functional cold room, forcing reliance on neighboring districts for vaccine storage. He added that the absence of clear budget lines for immunization weakens monitoring and accountability.
In Kenema District, DHMT officials and CSOs cited delayed fund disbursements, poor maintenance of health infrastructure and lack of transparency in budget implementation. The DHMT, which oversees 132 health facilities, also appealed for urgent rehabilitation of health centers and improved ambulance services.
Musa Ansumana Soko, Team Lead for WASH-Net Sierra Leone, also addressed the meeting, commending the collaboration between councils, CSOs and development partners under the GAVI-GHAI project.
“This project has helped us understand key barriers holding back progress in healthcare financing. The lessons from this phase will inform the next stage of the initiative, as we continue to deepen our engagement with Civil Society,” he said.
District Coordinators shared mixed results, with Falaba District reporting an increase in budget allocations from NLe 8,000 to NLe 10,000 for immunization and primary healthcare, while Bombali District did not make a presentation amid concerns over cooperation from its council.
Despite the challenges, Abdurahman Keys, Director of the West Africa Youth Network for Peace Education and Economic Development (WAYNPEED) and chair of the session, commended the councils for making progress in prioritizing domestic health financing.
“We’ve witnessed some positive steps, especially in the area of primary healthcare and immunization financing,” Abdurahman Keys noted. “With domestic resources collected locally, councils are beginning to create budget lines that reflect health priorities. We believe that as we continue to sustain this approach, there will be more gains in supporting primary healthcare and immunization financing.”
At the conclusion of the meeting, participants agreed on the need for continuous collaboration between District Councils, Civil Society and national stakeholders to ensure the sustainability of Sierra Leone’s healthcare system amid shrinking donor support.
