By Evanno Jerome / Paroles Autour de la Santé

As a low-income West African country, Sierra Leone like other countries in West Africa have real “problematic” policies (drug laws) around drug use and people who use drugs (PWUD). This mission provided a better understanding of the context of drug use and drug policies or laws in Sierra Leone. The methodology included a bibliographic research, interviews (semi-structured, individuals and collectives) with many actors and different profiles, participant’s observations and focus groups (FGs), facilitated the collection of data that was used for analysis and recommendations. Out of an estimated number of 5000 ‘problematic/precarious’ PWUD in Freetown. They frequent at least a 100 open consumption scenes. It seems difficult to directly consume the drugs (Heroine and crack) on the spot. The main illegal drug consumed remain to be cannabis.

Particular to Sierra Leone, the consumption of synthetic cannabinoid is becoming more popular. However, we were able to observe and confirm a significant consumption of cocaine in the form of crack, and non- prescription drugs (tramadol, valium, diazepam, etc.). The participative observations are not able to directly confirm the presence of Heroine and injecting drug's users. NGOs and Drug Users confirmed their presence. “But they are few, and less numerous compared to Libéria”. At first, it was easy to observe, that interventions related to the use and abuse of drugs (from a global health point of view), will require a multisectorial and holistic approach. The analysis of the data collected revealed a strong will on the part of all stakeholders to reform the current laws or policies and strong expectations and needs on the part of the PWUD.

Sierra Leona have the first official Needles and Syringes exchange Program (NSP) in West Africa (WA). Funded by Global Fund (GF), this program was visited during the mission. Some known actors, are already investing in Harm Reduction (HR) Programs and on drugs policy. HR is included in the national plan and on the NFM3 of the GF. Globally, PWUD have declared their simple needs and Primary care: "for housing, food, access to healthcare and social integration", and “to put the drugs at distance”.