Civil society advocacy for domestic investment in epidemic preparedness
Creating an ecosystem of civil society organizations committed to pandemic preparedness and response
From 2018 to 2025, we partnered with the Global Health Advocacy Incubator (GHAI) and more than a dozen African civil society organizations to advocate for increased domestic funding for epidemic preparedness.
On this page, you will find:
- An overview of methods and outcomes
- An in-depth report on boosting civil society advocacy for domestic investment
- Deep dives into unique country experiences
- Key lessons from seven years of advocacy
The challenge
African countries have long recognized the need to allocate domestic funding for public health, but progress has been slow. Bilateral and multilateral donors and development banks have funded a significant portion of countries’ health security efforts. This has resulted in under-resourced systems, a bias towards response over preparedness, and heightened vulnerability to shifts in external funding priorities.
The solution
Since 2018, Resolve to Save Lives and GHAI partnered with 15 civil society organizations in nine countries—Ethiopia, Ghana, Kenya, Nigeria, Senegal, South Africa, Tanzania, Uganda and Zambia—to increase domestic investment in epidemic preparedness.
Activities ranged from landscape analyses, participation in key national processes such as Joint External Evaluations (JEEs) and the development of costed National Action Plans for Health Security (NAPHS), political and budget process mapping, legal and policy reviews, coalition building, multi-pronged advocacy campaigns, high-level government engagement, subnational engagement, media training, journalism fellowships, public mobilization and budget tracking.
CSOs’ technical capacity in both budget advocacy and health security were reinforced through peer learning and mentorship, trainings and the development of several bespoke tools—such as the Budget Advocacy Framework, Toolkit, and Facilitator’s Guide—to strengthen advocacy efforts.
The impact
RTSL, GHAI and the CSOs they partnered with have changed national conversations about epidemics, mobilized political commitments and increased national investments in epidemic preparedness. They have demonstrated that civil society has tremendous power to change policy and bolster domestic investments.
In Nigeria, the federal epidemic preparedness budget increased by one-third since 2021, and the budget of the Nigeria CDC tripled since 2019. In Senegal, the Public Health Emergency Operations Center tripled its budget from CFA 50M in August 2018 to CFA 150M in August 2020. In Uganda, more than $15 million of newly budgeted money was dedicated to COVID-19 response and epidemic preparedness in 2024. And in Nigeria, Ethiopia and Ghana, local-level epidemic preparedness funds were established in 50 localities.
Deep dives
Key lessons learned
Over a seven-year period, RTSL, GHAI and CSOs proved that it is possible to secure political commitment to and increased national investments in epidemic preparedness. The lessons learned from this partnership are especially useful in a rapidly shifting environment where major international donors—USAID, PEPFAR, the Global Fund and WHO—are slashing their aid budgets, and Official Development Assistance (ODA) is shrinking. In this context, emerging models like the CSO Academy hold tremendous promise, demonstrating that targeted, strategic investments paired with sustained relationship-building produce resource-efficient results.
Here are other major findings:
- Relationships rule: Coalitions successfully advocated for epidemic preparedness when they had meaningful relationships with a variety of stakeholders, extensive knowledge of the local context and strong track records that bolstered their reputation.
- Innovation is essential: Emerging models like the CSO Academy demonstate that targeted, strategic investments, paired with sustained relationship-building, produce resource-efficient results and significant impact.
- Windows open and close: External factors—everything from elections to increasing debt burden—have tremendous impact on campaign success and often require advocates to revise once promising strategies and pivot accordingly
- Ecosystems are invaluable: Ensuring sustained support for pandemic preparedness mandates building capacity among diverse actors who have the knowledge and passion to run effective funding campaigns even when formal programming and initiatives like the CSO Budget Advocacy Academy conclude.
- Global context counts: Enthusiasm for and commitment to domestic investment in epidemic preparedness changes—and is heavily influenced by global events.