Debt Swaps in Practice: Lessons from Sierra Leone’s High-Level Conversations

In Episode 1 of Centers & Margins, I explored why debt swaps caught my attention as a possible tool for expanding Sierra Leone’s fiscal space for health. But moving from an idea to something real required testing the waters with those who mattered most.

In this episode, I share how we took those early steps: learning from the Global Fund’s experience across 12 countries, engaging the Minister of Health, navigating initial hesitation from a senior member of cabinet, and eventually securing buy-in from the Minister of Finance and his team.

These conversations were not always straightforward. They revealed concerns about optics, institutional capacity, and political economy but they also showed what it takes to shift a financing idea from theory into a credible reform pathway.

Join me as I reflect on what it means to build momentum for reform in real political contexts and the lessons I have carried forward about listening, framing, and persistence.