Designing a focused and impact-oriented second strategic National Action Plan for Health Security in Sierra Leone, 2025: Process, best practices and lessons learnt

Victor Caulker^1*Mustapha Jalloh²Robert Musoke¹James Sylvester Squire²Mohamed Vandi²Foday Sahr²Michael Ndolie¹George Ameh¹Lily Kainwo²Sahr Gbandeh²JOSEPH SAM KANU²Rachel Sandi²Mohamed Boie Jalloh²Saidu Bamayange³Foday Mohamed Sheriff³Momoh Massaquoi⁴Osman Baimba Koroma⁴Roland Wango⁵Dick Chamla⁵Ian Njeru¹

• ¹World Health Organisation Country Office Sierra Leone, Freetown, Sierra Leone
• ²National Public Health Agency, Freetown, Sierra Leone
• ³Ministry of Agriculture and Food Security, Freetown, Sierra Leone
• ⁴Ministry of Environment and Climate Change, Freetown, Sierra Leone
• ⁵World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo

Introduction: The National Action Plan for Health Security (NAPHS) is a country-owned, whole-of-government and all-hazards strategic plan for strengthening health security. In 2025, Sierra Leone developed its second NAPHS (2025-2029). We share the process, lessons learned and best practices adopted during the process. Methods: This was an observational qualitative descriptive study that was conducted between June 2024 and April 2025. It was guided by the 2024 WHO NAPHS implementation toolkit and data was collected through direct observation and documentation of key activities undertaken during the NAPHS development process. Additional information was collected from key informants drawn from stakeholder groups that participated in the process. This data was collected using a semi-structured questionnaire administered via an online Google Form. Results: The NAPHS development process was led and coordinated by the National Public Health Agency and all One Health sectors, partners, academia and civil society participated in the process. The process demonstrated strong national ownership, multisectoral engagement, systematic documentation, evidence based planning and alignment with national priorities. Lessons included the importance of early planning, stakeholder communication, sustainable financing and conducting end term NAPHS evaluation. The five-year plan was costed at USD 91.6 million, with 29% of funds required for the initial two years secured. The cost of developing the plan was $75,000. Conclusion: The Sierra Leone's experience demonstrates that even in resource-constrained settings, a nationally led, evidence-based, and prioritized approach to health security planning is feasible and impactful. We recommend adequate resource mobilization to ensure the plan is implemented successfully.