“Our Advocacy Really Prevented an Epidemic”: Updates from Zambia and Ethiopia

We interviewed two of our partner civil society organizations (CSOs) who successfully advocated for domestic funding in epidemic preparedness as part of the first cohort of the Advocacy Accelerator program (2024-2025). What we learned: The impacts continue well beyond after the program ends.  

The Advocacy Accelerator is the Global Health Advocacy Incubator (GHAI)’s 10-month practical learning program that strengthens CSO’s capacity to influence domestic health financing based on GHAI’s tested model of CSO-led budget advocacy. It combines hands-on learning, expert mentorship and peer exchange to strengthen skills in budget analysis, campaign design and government engagement. The CSOs immediately put the new skills into practice through a practical capstone project, gaining real-world results.  Here are two examples: 

Zambia: Anchoring Epidemic Preparedness in Domestic Resources 

Lusaka, the capital of Zambia, is home to approximately 3 million people, and is a hub for economic, social and political life. But its density and mobility also make it uniquely vulnerable to outbreaks. As Amos Mwale from the Centre for Reproductive Health and Education (CRHE) Zambia explained: "Lusaka is a meeting point. People come from everywhere and then disperse back to other provinces. So if something starts here, there's an immediate risk it will be carried to other provinces within a very short time." 

Every rainy season, that vulnerability used to translate into cholera outbreaks. But this year, something changed. 

"We're lucky that this year we’ve seen very few cases. I attribute that to improved surveillance systems, and the preparedness work we've been doing." 

That preparedness work was the result of sustained, strategic advocacy by Mulenga Ching’ambo and Amos Mwale through the first cohort of GHAI's Advocacy Accelerator (previously called the Advocacy Academy), which concluded in March 2025.

CRHE Zambia's capstone project set out to secure a dedicated district-level budget line for epidemic preparedness in Lusaka. The team presented evidence of the need for funding and recommendations to the Parliamentary Committee on Health. The National Assembly adopted eight of these recommendations, contributing to a 15% increase in the health sector's budget for emergency preparedness. 

Amos described what made the advocacy effective: "We learned how to analyze a budget; how to actually read the numbers and understand what they mean for epidemic preparedness. We learned how to summarize evidence clearly and how to develop an advocacy brief that highlights your issue in a way decision-makers can act on. We also learned how to develop specific recommendations: not just saying 'we need more money,' but identifying the exact budget line, how much currently exists, and how much is needed." 

Perhaps more significant than the budget increase itself is what the funds are being used for: the government has taken over salary payments for surveillance and laboratory staff (pictured here) who were previously funded by donors. Office costs, vehicle maintenance and utilities for surveillance operations are now covered by domestic resources.

“The government has taken up payment of staff and administrative costs. That's the key outcome." 

This marks a real shift away from donor dependency. CRHE continues to push further: their ongoing target is for the government to fund at least 80% of epidemic preparedness costs, with donors covering no more than 20%. 

Reflecting on what made their advocacy successful, Amos offered a lesson for any civil society organization: 

"When you speak as a united voice, people listen. They trust what you're saying and feel supported by the breadth of people saying it. If you're all asking for the same thing with the same evidence, it's much harder for decision-makers to dismiss. And critically: when you prepare together as stakeholders, ensuring that everyone is using the same agreed-upon facts and data, you eliminate the risk of conflicting information reaching the people who matter." 

Now, with the 2026 cholera season behind them, and with significantly fewer cases than in previous years, CRHE is using this success as evidence in the current district-level budget planning cycle. The argument, as Amos put it, is simple: "It worked. Let's sustain it." 

Ethiopia: Zero Cholera Cases in Kalu Woreda 

In Kalu woreda (district) in Ethiopia's Amhara region, the approach to epidemics used to be reactive instead of proactive.  

"They used to start acting and start working after the epidemic happened. The budget may have been allocated, but it has never been disbursed for preparedness before." That's how Yemisirach Tadesse from PADeT described the status quo when she and her colleague Engdawork Worku joined our 2024–2025 Advocacy Accelerator cohort. 

Kalu is a densely populated district prone to waterborne diseases, particularly during the large Muslim and Christian religious gatherings that draw crowds to sites with limited sanitation. Historically, cholera outbreaks followed almost every mass gathering season. 

Through the Accelerator, PADeT successfully advocated for the first-ever budget line for epidemic preparedness in Kalu district; and crucially, for that budget to actually be disbursed and used. 

"Because of our advocacy, the government has not only allocated a budget but also has been able to disburse it. The budget was utilized for epidemic preparedness, purchasing medicines, personal protective equipment (PPE) materials, gloves, so that the health facilities are now prepared and well-equipped for epidemic response." 

The 500,000 Ethiopian Birr (approximately 3,000 USD) allocated were 100% utilized: PPE, medical supplies and gloves were procured and distributed across nine health centers. A rapid response team of 49 health professionals was trained over two days in surveillance, detection, reporting and early response. Temporary toilets were installed and materials distributed ahead of mass gatherings. The district’s government focal person, who oversees surveillance and epidemic response, thanked the team for making it happen. "This is really a big win for us. It feels like a dream, really."

The result of all this preparation? During this year's highest cholera risk period there were zero confirmed cases. "There were 30 suspected cases. But none of them were cholera. Cholera didn't happen.” 

And the government has already allocated the same amount again for the following year. 

The Accelerator program focuses on real life, practical capstone projects instead of just theory. For Yemisirach, this is what resulted in the win: "I had received advocacy training so many times (before joining the Accelerator) but never had a chance to really act on it. With this program’s guidance and mentorship, we learned how to implement advocacy at the ground level, into action. And it really works." 

PADeT is now sharing its model with other civil society organizations. For Yemisirach, the message she wants to carry forward is clear: 

"If we have the practical skills and a good relationship with stakeholders, advocacy wins are possible. We have done it. And Kalu is just a starting point." 

From Lusaka, Zambia, to Kalu district, Ethiopia, the pattern is the same: when CSOs are equipped with the right tools, mentoring and evidence-based approaches, they can move governments to act before epidemics strike. 

The Advocacy Accelerator program is currently in its second year, with a third cohort starting this August. The CSOs from cohort 1 and cohort 2 are now working together in our Budget Advocacy Community of Practice, with regular collaborative meetings for CSO-to-CSO exchange. Many of the CSOs are continuing the advocacy efforts they started during the Accelerator, and are sharing their insights with each other.