A total of NLe1.5 billion has been allocated for the health sector in fiscal 2025. This lion share accounts for about 9 percent of total primary expenditures.

This substantial allocation highlights the government's intent to prioritize health in areas where access to quality healthcare services is crucial for sustainable development. Among the key highlights of the recurrent expenditure for the health sector, the Minister detailed an allocation of ‘NLe131.7 million’ from the recurrent budget to the Ministry of Health. Significant portions of healthcare is strategically distributed to cover essential services and operational expenses, which include:

- Tertiary Hospitals and Ambulance Services: NLe41.2 million.
- Primary Health Services: NLe16.1 million.
- Reproductive and Child Health Services: NLe10.9 million.
- National Medical Supplies Agency: NLe64.4 million (of which NLe42.2 million is earmarked for the procurement of free healthcare drugs).
- National Public Health Agency: NLe9.0 million.
- Health Service Commission: NLe6.5 million.
- Transfers to Local Councils for Devolved Health Functions: NLe61.8 million

Furthermore, a significant segment of the budget goes toward the remuneration of health workers, with an apportionment of ‘NLe1.0 billion’ designated for wages and salaries for health personnel, in addition to ‘NLe56.2 million’ for the salaries of staff at allied health agencies. This underscores the government's recognition of the importance of human capital in the health sector, particularly in enhancing service delivery and maintaining healthcare quality.

The government is also making notable capital investments to address the infrastructure challenges plaguing the health sector. From the domestic capital budget, a total of ‘NLe30 million’ has been allocated to the Ministry of Health, which will fund crucial projects aimed at enhancing healthcare facilities:

- Construction of a Cancer and Diagnostic Medical Centre: NLe20 million
- Rehabilitation and Expansion of District Hospitals: NLe10 million

These capital expenditures signify a proactive approach to strengthening the healthcare infrastructure, addressing disparity in service delivery, and enhancing access to specialized medical services. To augment domestic financing efforts, development partners are stepping in with significant contributions. The Minister elaborated that ‘NLe388.5 million’ will be disbursed by various partners, including the World Bank, Islamic Development Bank (IsDB), BADEA, Kuwaiti Fund, and Global Fund. These funds will support diverse projects in the health sector, including the construction of a Pharma Grade Warehouse—another critical need in bolstering pharmaceutical management and supply chains within Sierra Leone.

Additionally, the government is backing these initiatives with ‘NLe72 million’ as a counterpart contribution for donor-funded projects in the health sector, further solidifying collaborative efforts to enhance health outcomes.

The government’s strategy encompasses both recurrent and capital expenditures, reinforcing its commitment to improve healthcare services through increased funding for essential services and infrastructure development. With ongoing support from international partners alongside domestic investments, MTNDP 2024-2030 objectives outlined will yield the desired impact on public health.

The government recently announced that the budget deficit, excluding grants for the 2025 year is projected at NLe16.4 billion; about 8.5 percent of the Gross Domestic Product (GDP).

A deficit of this magnitude is significant and indicates ongoing struggle to balance revenue generation against expenditure needs. It is reflective of the country's increasing need for financing, which is crucial for public sector operations, infrastructure projects, and essential services. There’s a projected shortfall of NLe7.5 billion with grants which represents a notable gap that must be addressed strategically.

Government has equally announced its intention to finance the gap primarily through domestic borrowing. "The deficit, including grants, will be financed mainly by borrowing from the domestic banking system projected at NLe6.1 billion (3.1 percent of GDP)." This signifies the state’s intention to rely on local financial institutions for liquidity. This undoubtedly would bolster the banking sector. However, it raises concerns on the possibility of that move crowding out private investment. In addition to domestic borrowing, the government anticipates the mobilization of NLe640.3 million (0.3 percent of GDP) from the non-bank sector. This strategic move underscores a multi-faceted approach to financing the deficit, illustrating the government's intent to diversify its sources of funds to mitigate risks associated with heavy reliance on a single sector.

The decision to pursue such financing have varying implications for the economy. Securing funds through local banks can stimulate the economy, enabling public investment in infrastructure and services that drive growth. On the other hand, significant borrowing may lead to higher interest rates and exert pressure on government revenue in the future thereby creating a cyclical problem of increased debt servicing costs. The need for a comprehensive budget deficit financing cannot be overstated. In this direction, the government should consider the following:

- Revenue Enhancement: To ensure sustainability, there is need for exploration of avenues for improving tax collection and enhancing non-tax revenue streams. Efficient revenue mobilization systems can help reduce dependency on borrowing.
- Investment in Growth Sectors: Focus also can be placed on sectors that promise substantial returns, such as agriculture, mining, and tourism, ensuring that borrowed funds are utilized effectively to stimulate economic growth.
- Monitoring and Evaluation: Establishing robust monitoring mechanisms for budget execution can assist in assessing the impact of borrowing on economic performance, ensuring transparency and accountability.
- Public Debt Management Strategy: Developing a long-term debt management strategy will be essential to avoid excessive borrowing that might jeopardize fiscal stability.

A consortium of World Bank, the African Development Bank (AfDB) and the Indian Export -Import (EXIM) Bank is disbursing a total of NLe1.4 billion for the implementation of several projects in the energy sector in the next fiscal year.

Already earmarked projects include the Regional Emergency Solar Power Intervention Project (RESPITE). The EU is supporting improvement in energy access under the Transformational Energy Access for Sierra Leone Project. The Sierra Leone government is providing NLe4.2 million as counterpart contribution towards the implementation of these projects. In addition, Government is also providing NLe5.9 million for administrative expenses and NLe9.8 million for wages and salaries to the Ministry of Energy. The government is allocating a total of NLe127.3 million to the energy sector in fiscal 2025. This is being provided from the 2025 domestic capital budget Of this, NLe50 million is to be expended on the completion of the 7 districts electricity projects in the country.

A total of NLe26 million is earmarked for the rehabilitation of the Goma-Dodo Hydro Dam and NLe 26 million for the extension of transmission and distribution lines to mining companies. A total of NLe25.5 million is for enhancing energy generation and transmission.

Furthermore, Government is providing NLe875.0 million as subsidies to EDSA for the payment of outstanding invoices to the Independent Power Producers (IPPs), including Karpower, CI-Energy, and TRANSCO-CLSG.