By Mohamed Sheriff, Information Attaché, Geneva, Switzerland
Sierra Leone’s Minister of Health, Dr. Austin Demby, has presented the country’s early progress on the implementation of its National Health Compact during a distinguished speakers’ roundtable hosted by Seed Global Health, bringing together Sierra Leone, Uganda, and other international partners.
Addressing delegates, Dr. Demby stated that Sierra Leone is not merely promoting the concept in theory but demonstrating what a functioning National Health Compact looks like in practice.
He recalled that Sierra Leone officially launched the Compact in Tokyo in December 2025 under the framework of “One Plan, One Budget, and One Reporting Framework,” co-signed by major development partners and jointly governed by the Ministries of Health and Finance.
Speaking on the four pillars of the Compact—Alignment, Acceleration, Accompaniment, and Accountability—Dr. Demby explained that alignment requires strong coordination between the Ministries of Health and Finance to ensure that national systems take precedence over parallel donor structures.
On acceleration, he highlighted the government’s “300 Days of Activism for Triple Zeros” campaign, describing it as a presidential accountability initiative focused on reducing maternal deaths, child deaths, and the number of unvaccinated children through real-time monitoring systems.
According to him, by Day 75 of implementation, maternal deaths had reduced by 60 percent compared to the 2025 baseline.
Dr. Demby acknowledged that accompaniment remains a work in progress, noting that some partners still operate parallel reporting systems despite signing the Compact. He stressed that true partnership goes beyond commitments made at signing ceremonies.
On accountability, he pointed to the establishment of live dashboards, district heat maps, weekly review mechanisms, and real-time Triple Zeros monitoring systems as evidence that Sierra Leone’s accountability architecture is already operational.
Addressing financing, the Health Minister emphasized that Sierra Leone’s approach is rooted in domestic resource mobilization. He disclosed that the government is pursuing the Abuja Declaration target of allocating 15 percent of the national budget to health, while also exploring health taxes on tobacco, alcohol, sugar-sweetened beverages, and unhealthy packaged foods.
He further revealed plans for the Sierra Leone Social Health Insurance Scheme (SLeSHI) and ongoing discussions around debt swaps for health investments.
Dr. Demby concluded by offering Sierra Leone as a reference country for nations seeking to establish similar health compacts, encouraging countries to learn not only from Sierra Leone’s successes but also from its implementation challenges.
