Sierra Leone has successfully completed the End-Term Review (ETR) of its National Tuberculosis (TB) Strategic Plan (2021–2025), a pivotal exercise aimed at evaluating the country’s progress in the fight against TB, identifying ongoing challenges, and setting priorities for the next strategic phase. The review process, which began in March 2025, included comprehensive epidemiological and programmatic assessments conducted from 1 to 12 September 2025.

Led by the Ministry of Health (MoH) and the National Leprosy and Tuberculosis Control Programme (NLTCP), the review benefited from robust technical and operational support from the World Health Organization (WHO) and partner organizations. WHO’s engagement drew on expertise from its headquarters, the Regional Office for Africa (AFRO), and the Sierra Leone Country Office, ensuring that the review adhered to global standards while reflecting the realities on the ground.

The End-Term Review was not only an evaluation exercise but also a capacity-building opportunity. National staff played a central role in leading and implementing the review, with WHO and partners providing guidance and technical support. This approach strengthened national ownership and ensured that the recommendations and findings were grounded in local contexts, enhancing their relevance and feasibility.

The objectives of the review were to measure the progress achieved under the current strategic plan, highlight both successes and persistent challenges, and generate evidence to inform the next National TB Strategic Plan (NSP) for 2026–2030. The review confirmed notable achievements, including improved TB case finding, effective treatment coverage, integration of TB and HIV services, expanded access to TB diagnostics and universal drug susceptibility testing (DST), decentralization of drug-resistant TB (DRTB) care, and the scale-up of shorter regimens for both TB preventive treatment and DRTB therapy. At the same time, the review revealed ongoing challenges such as undetected TB cases, systemic health limitations, financing gaps, and the need for stronger social protection measures for patients.

Despite the constraints posed by limited resources due to funding reductions, the ETR was successfully completed, demonstrating Sierra Leone’s strong national commitment, resilience, and effective collaboration with partners. The insights from this review are set to guide the development of the 2026–2030 NSP, scheduled to begin in October 2025, aligning with global End TB targets and the country’s broader health priorities.

Looking forward, the findings underscore several critical areas for action in the next strategic plan. These include the need to mobilize domestic resources to reduce reliance on external funding, respond to updated WHO TB burden estimates for Sierra Leone, and strengthen multisectoral accountability and collaboration. Additionally, scaling up active TB case finding, expanding the role of community health workers, addressing social protection gaps, improving data digitization and utilization, and integrating TB services with broader health programs such as HIV, reproductive, maternal, newborn, child, and adolescent health (RMNCAH), and non-communicable diseases are highlighted as essential measures for sustaining progress.

The WHO Country Office in Sierra Leone extends its sincere appreciation to the Ministry of Health, WHO AFRO, WHO headquarters, the Global Fund, the CDC Foundation, healthcare workers, implementing partners, and all stakeholders supporting the TB program. Their collective dedication underscores the power of partnership in driving progress and brings Sierra Leone closer to the ultimate goal of ending TB.