Sierra Leone’s Minister of Health and Sanitation, Dr. Alpha Wurie (right in photo), capped an extraordinarily busy week at the World Health Organisation’s 72nd annual General Assembly in Geneva, Switzerland, with a lengthy bilateral meeting with WHO’s Director General, Dr. Tedros Adhanom Ghebreyesus (left in photo), on Friday 24 May. Dr. Wurie earlier held fruitful meetings with Cuba’s Minister of Public Health, Jos� Angel Portal Miranda, who extended an official invitation to the Sierra Leone Health Minister to formalise a medical assistance package.

As in the Cuba meeting, Minister Wurie was accompanied by Sierra Leone’s Ambassador and Permanent Representative in Switzerland, Dr. Lansana Gberie, who facilitated the meetings.

In the meeting Dr. Wurie briefed the WHO Director General on his government’s plan to ensure Universal health coverage, using existing hospitals and community health centres as hubs in all 16 districts. Dr. Wurie noted the constraints in implementing the ambitious program as including the fact that two new districts created by the previous government, Karene and Falaba, do not have district hospitals that can serve as hubs. The focus in their cases will be on upgrading the existing community health centres for the short to medium terms.

Another innovation to help facilitate the universal health coverage in Sierra Leone will be use of Specialist Outreach Services, which will include local as well as diaspora medical specialists. There is a need to attract diaspora specialists, Dr. Wurie said, because of the sheer paucity of specialists in the country – only about 30 specialists serving a population of 7 million. Sierra Leone currently has only four properly trained and qualified obstetricians and gynaecologists, and only two radiologists. Dr. Wurie said that his Ministry will be drawing support from the Afro-European Medical and Research Network (AEMRN), whose President, Dr. Charles Senessie, a Sierra Leonean academic based in Switzerland, had his medical Education at the College of Medicine and Allied Health Sciences (COMAHS). Dr. Wurie later held lengthy discussions with Dr. Senessie in Geneva.

The WHO Director General expressed his admiration for the program and recounted his own experiences as health Minister in Ethiopia when a similar program was launched. He promised to help Sierra Leone with technical and other support, including help in acquiring needed equipment to facilitate the universal health coverage as well as training of staff.

Shortly after Dr. Wurie’s meeting with the WHO Director General, he spoke at the WHO 72nd Plenary Meeting. See below Dr. Wurie’s statement:

Statement by Hon. Dr. Alpha Wurie, Hon. Minister of Health and Sanitation at WHO 72 Plenary Meeting on 21 May 2019

Mr. Chairman, Colleague Ministers, I bring you warm greetings from His Excellency the President, Brig. (Rtd.), Julius Maada Bio and the People of Sierra Leone.

The name Sierra Leone may bring memories of the Ebola outbreak in 2014 and the Mudslide in 2018; both of which, exposed the weakness of the health systems.

I however will like to report a silver lining as a consequence of these horrendous events.
Firstly, Government’s commitment to the health sector has been remarkable. The expenditure to the health sector in the budget has moved from 7.5% in 2018 to 11% in 2019; hoping to get to the Abuja Target of 15% by 2020.

An external evaluation by WHO country office affirmed considerable progress in the development of policies and structures to respond to health emergencies. The disease surveillance and laboratory platforms are now capable of detecting epidemic prone diseases in real time. The detection of the Bombali and Marburg viruses in recent times is a reflection of the improvement in our science base. The health sector could now be reasonably considered as robust with its preparedness for disease detection and outbreaks responses.

This is now a good platform to strengthen primary healthcare services as the bedrock to Universal Health Care.
Firstly the health workforce is to increase by 40%; 15% were recruited in March and 25% will be recruited in September 2019. Furthermore, 200 Community Health Nurses (SECHNs) are receiving upgraded training to Registered Nurses (SRN) and 200 Certificate Midwives upgraded to Diploma Midwives. Further, redistribution of trained health personnel from hospitals to community health centres will be a major step for equitable service.

Recognizing a weakness in medicines, and medical supply chain, an Act of Parliament has established an Agency to bring efficiency and effectiveness to procurement, storage and distribution of medicines and medical supplies to support hospitals and community health services.

In the recognition that maternal deaths are related to teenage pregnancy, the First Lady championed the programme “Hands off our Girls”, which reverberated nationwide through Paramount Chiefs and their wives.

Stiff legislation against gender violence and rape has considerably reduced adverse/accidental events against adolescent girls and women.

Reproductive, maternal and child health services are considered as key in the universal health care. We are addressing the “Three Delays” that are deemed to contribute to maternal deaths by establishing the Ambulance Services to significantly reduce the time for a pregnant woman to access hospital services, solar refrigerators for Blood Services and laboratories in Community Health Centre to conduct 20 basic tests.

Furthermore, we recognize the School as a vital institution for an expanded Health programme. School Health is being strengthened and expanded to integrate family planning, compressive sexuality education, sexual and reproductive services. Also the significant rise in NCDs (Cardiovascular diseases, hypertension, Diabetes and cancers) has warranted Government to develop and implement policies & strategies on NCDs including Mental Health, tobacco use and substance abuse in schools

Concluding, Sierra Leone has learned lessons from the Ebola outbreak and Government through a win–win partnership and collaboration with donors, civil society and communities continues to strengthen the health systems towards universal health coverage and national development.