Malawi is one of the poorest countries in the world. The government has introduced some measures to improve the health of its people, but a number of major problems remain. One of these is the lack of essential medicines in government health clinics – known as ‘stock-outs’. These medicines should be free to poor people, but most find that they have to pay. This case study – one of a series of Programme Insights on Local Governance and Community Action – looks at an innovative campaign which aimed to tackle this problem by enhancing the capacity of local communities and civil society organizations to demand the right to access these medicines. The campaign lobbied for a commitment to increased availability and accessibility in rural areas and carried out budget and resource tracking. The case study looks at the difficulties the campaign faced and outlines the factors that contributed to its success.