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

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 were 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. These data were collected using a semistructured 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 5-year plan was estimated to cost USD 91.6 million, with 29% of funds required for the initial 2 years secured. The cost of developing the plan was $75,000. Conclusion 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.