World Health Day 2024: Sierra Leone Falls Short on 15% Health Budget Commitment
By: Christian Conteh
As the world commemorates World Health Day, shining a spotlight on global health disparities, Sierra Leone finds itself grappling with persistent challenges in healthcare access and funding allocation. Despite commitments made in the Abuja Declaration of 2001 to allocate at least 15% of the national budget to healthcare, Sierra Leone has yet to fulfill this crucial pledge, further exacerbating the country's healthcare woes.
Sierra Leone, among the least developed nations globally, faces numerous obstacles to healthcare access, including geographical barriers, high out-of-pocket expenditures, insufficient medical staff, and uneven distribution of resources. The majority of referral hospitals and healthcare professionals are concentrated in the capital city of Freetown, leaving rural populations underserved and vulnerable.
Recent revelations underscore the severity of the situation. BudgIT Sierra Leone, a prominent advocacy organization, has highlighted the persistently low budget allocations to the health sector. In 2022 and 2023, healthcare received only 7% and 6% of the national budgets, respectively, significantly below the 15% benchmark set in the Abuja Declaration.
“The health sector was allocated NLe896.7 million ($39.5 million) in 2022 and NLe 938.7 million ($41.3) in 2023, representing 7% and 6% of the national budgets, respectively,” BudgIT notes.
This chronic underfunding directly impacts citizens, leaving many without access to essential healthcare services and contributing to preventable diseases and high mortality rates.
Moreover, the government's budget priorities raise concerns about misplaced expenditures. Despite the glaring need for increased healthcare funding, the allocation for medical expenses abroad exceeded the budgeted amount by a staggering 13.75% in the fiscal year 2024, marking it as the costliest expenditure. Such discrepancies highlight the urgent need for realignment of budgetary allocations to prioritize domestic healthcare needs.
“During the FY2024 Policy Hearing and Bilateral Budget Discussions it was revealed that the government budgeted NLe 2 million ($89,286) for medical expenses abroad and spent NLe 29.5 million ($1.3m), a 13.75% increment from the allocated sum and the costliest expenditure in the budget,” the advocacy group noted.
During the Policy Hearing and Bilateral Budget Discussions for the fiscal year 2024, additional challenges plaguing the healthcare sector came to light. These include late disbursement of funds, inadequate medical equipment, shortage of specialized medical personnel, reliance on unpaid volunteers, weak infrastructure, and outdated revenue collection methods. These systemic shortcomings further strain an already fragile healthcare system, hindering efforts to improve health outcomes and drive economic development.
On the Global stage, The World Health Organization (WHO) marks its establishment by launching the "My Health, My Right" campaign on World Health Day, emphasizing equitable access to quality health services for all. Despite progress, challenges such as political apathy, insufficient funding, and discrimination persist, disproportionately affecting marginalized populations. With over half the world lacking access to essential health services and financial barriers hindering care, substantial investments are needed.
WHO urges governments to prioritize primary healthcare, enforce laws, and promote transparency. Recognizing health as a fundamental right, the campaign extends to various sectors, calling for collective action to ensure universal health coverage and rights for all individuals.