The Directorate of Drugs and Medical Supplies (DDMS) plays a key role in providing technical guidance and setting strategic direction in policy formulation, service delivery, standards, laws and regulations, and objectives for the pharmaceutical sector in Sierra Leone. It is also involved in stakeholders’ collaboration and coalition building, resource mobilization and deployment of resources, monitoring, and oversight. It is therefore necessary to review and finalize the DDMS structure at all levels to reflect this expanded role, especially with regard to the ongoing decentralization process, the necessary capacity that needs to be developed, and aligning DDMS’ work plan with SIAPS. As part of SIAPS’ system strengthening strategy and by way of addressing the challenges identified during implementation interventions for pharmaceutical supply chain management, SIAPS, in collaboration with DDMS, has identified those topics that would be most valuable for sustained, effective leadership and systems to drive the success of the pharmaceutical sector in Sierra Leone.