By George M.O. Williams
Sierra Leone has made significant strides in reducing HIV-related deaths, with annual fatalities dropping from 4,000 to about 1,800 in recent years. Yet, more than 3,000 new infections continue to be recorded annually, posing a serious challenge to the country’s ambition of ending AIDS by 2030.
On December 1, Sierra Leone will join the global community in commemorating World AIDS Day under the theme “End AIDS By 2030: Keep The Promise.” Ahead of the event, a media breakfast was held on Saturday, November 29, 2025, at the Sierra Palm Hotel in Freetown, bringing together government officials, international partners, civil society organizations, and community groups to assess progress and reflect on the challenges ahead.
Funding Gaps and Call for Renewed Commitment
A major concern raised during the gathering was the lack of domestic financing for HIV programmes. Abdul Rahman Sesay, Director General of the National AIDS Secretariat (NAS), urged stakeholders to recommit to the national response.
“The day is not only for remembering those lost to HIV but also for recognizing our collective responsibility to do more, re-engage, and support each other,” Sesay said, stressing that ending AIDS depends on unified action. He highlighted the importance of strategic planning, particularly in reaching vulnerable populations and strengthening community support systems.
Current HIV Landscape
Dr. Sulaiman Lakkoh, Director of Disease Control at the Ministry of Health, provided an update on the national HIV situation. Since Sierra Leone’s first recorded case in 1997, prevalence has stabilized, with the 2019 Demographic Health Survey placing national prevalence at 1.7%.
- 81,000 people are currently living with HIV, including 6,000 children under 15.
- Prevalence is highest in the Western Rural District and lowest in Kailahun.
- Urban prevalence stands at 2.3%, nearly double the 1.2% observed in rural areas.
Dr. Lakkoh noted that young women and adolescents remain disproportionately affected. Among key populations, prevalence rates are particularly high: nearly 12% among female sex workers, 3.2% among men who have sex with men, and 4.2% among people who inject drugs and transgender individuals. Collectively, these groups number nearly 195,000 people, underscoring the need for targeted, stigma-free interventions.
Progress and Remaining Gaps
HIV-related deaths have declined by more than half, while new infections are also decreasing, with fewer than 3,000 recorded annually. Mother-to-child transmission has been reduced by 43%, marking an important step in preventing pediatric infections.
Sierra Leone has also made progress toward the global 95-95-95 targets:
- 87% of people living with HIV know their status
- 86% of those diagnosed are on treatment
- 65% have achieved viral suppression
However, viral suppression remains below global benchmarks, requiring renewed attention. Dr. Lakkoh emphasized that the Ministry of Health remains heavily dependent on international donors, whose support is increasingly unpredictable. Without increased local investment, sustaining progress will be difficult.
He also called for expanded HIV testing, consistent condom use, stronger community engagement, and intensified efforts to eliminate stigma. HIV testing, treatment, and prevention services, including PrEP, remain free nationwide.
Global Perspective and Warning
UN Resident Coordinator Seraphine Wakana cautioned that Sierra Leone risks falling behind global targets if current trends persist. She highlighted that 40.8 million people worldwide are living with HIV, with 1.3 million new infections recorded last year.
Wakana warned that the number of people living with HIV in Sierra Leone could rise to 3.3 million by 2030 if interventions are not intensified. Despite this, she expressed optimism, stressing that with the right investments, focus on key populations, and efficient use of resources, the country can still achieve its goals.
The Road Ahead
The message for this year’s World AIDS Day is clear: Sierra Leone can still end AIDS by 2030, but only if prevention efforts are scaled up, treatment access widened, funding increased, and no one left behind.
Representatives from the AIDS Healthcare Foundation (AHF), World Vision, UNFPA, SOLTHIS, and NETHIPS were among the organizations present, reaffirming their commitment to supporting Sierra Leone’s fight against HIV.