Strengthening Epidemic Preparedness Financing at the Subnational Level: A Success Story in Nigeria's Kano State

In the bustling heart of Nigeria, Kano State has emerged as a beacon of progress in epidemic preparedness and response (EPR). Thanks in part to a strategic collaboration between the Global Health Advocacy Incubator’s (GHAI) Prevent Epidemics program and civil society partners, the state has not only established a dedicated budget line for EPR but has also witnessed a substantial increase in funding over the past three years.

Recognizing the urgency of the situation, GHAI, alongside local partners the Legislative Initiative for Sustainable Development (LISDEL), BudgIT and Nigeria Health Watch embarked on a mission to garner public and political support for epidemic preparedness. This collaborative effort culminated in the formation of the Kano State Health Security Advocacy Team (KHESAT), a coalition that played a pivotal role in advocating for increased funding.

Nigeria Health Watch spearheaded a targeted media campaign with a dedicated hashtag—#PreventEpidemicsNaija. This initiative not only raised public awareness but also showcased citizens' calls to action and stakeholders' commitments toward bolstering health security policy and financing in the state. A 20-minute documentary and a Journalism Master Class organized by Nigeria Health Watch further fueled the momentum.

The turning point came when the Kano State government, influenced by concerted advocacy efforts, established a groundbreaking EPR budget line for the fiscal year 2021, allocating 300 million naira (approximately US $660,000). This marked the first of its kind in Nigeria. Subsequently, the budget line saw an increase, reaching 400 million naira (approximately US $883,000) for fiscal years 2022 and 2023. Furthermore, recognizing the diverse challenges posed by outbreaks, Kano secured commitments for EPR budget allocations in each of its 44 local government areas (LGAs) in fiscal year 2021. Notably, funding commitments increased by 50 percent in fiscal year 2022, totaling 132 million naira. This decentralized approach ensures that every corner of the state is equipped to respond effectively to potential health crises.

GHAI, LISDEL, BudgIT and KHESAT understood that budget allocations were not the end of the process. They continuously assessed budget needs, supported the development of the Kano State Action Plan for Health Security and ensured a monthly disbursement of 3 million naira (approximately US $6,600) for EPR activities from the Kano State Health Trust Fund. This strategic move, initiated in January 2023, bolsters both accountability and sustainability.

To fortify the gains achieved and foster even greater public health security, a public health security legal framework—the Kano State Public Health Security Bill—was developed with support from the Africa Centre for Disease Control, e-Health Africa, GHAI, LISDEL and Resolve to Save Lives. This framework sets the stage for a resilient and proactive response to future health challenges.

The success in Kano State imparts valuable lessons for similar efforts in other states in Nigeria. Stakeholder mapping, identifying advocacy champions and using evidence-based strategies are crucial for effective advocacy. Furthermore, the journey doesn't end with budget allocations; sustained advocacy is essential for the release and optimal utilization of funds.

Kano State's dedication to building a robust and prepared health security system stands as a testament to the impact of collaborative advocacy. With sustained efforts and a commitment to accountability, Kano has not only secured its present but has paved the way for a healthier and more resilient future. Read more about the work done in the case study.