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CONTEXT
Somalia continues to face one of the world’s most complex and protracted humanitarian crises, driven by a convergence of conflict, climate shocks, disease outbreaks and widespread displacement. Over three decades of armed conflict have fragmented the health system, leaving it under-resourced and unable to meet population needs. The country has some of the highest maternal mortality, childhood malnutrition and vaccine-preventable disease rates globally, exacerbated by poor health infrastructure, extremely low immunization coverage and a critical shortage of health workers.
Between January and September 2025, cholera affected more than 8180 people and caused nine deaths (a case fatality rate of 0.1%), primarily in areas with poor water, sanitation and hygiene (WASH) conditions. During the same period, a resurgence of measles resulted in nearly 8512 reported cases, largely due to high numbers of unvaccinated children under five, widespread malnutrition and limited access to primary healthcare in conflict-affected areas. A diphtheria outbreak further underscored the collapse of routine immunization, infecting over 2445 people - mainly unvaccinated children - and causing more than 116 deaths. Additionally, flooding facilitated the spread of vector-borne diseases such as malaria, dengue and chikungunya into previously unaffected districts.
Furthermore, 95% of Somalia’s health budget depends on external financing. Funding cuts mean that 618 health facilities - 51 district hospitals, 413 health centers and 154 primary health units - will likely close their doors in 2026. These facilities are lifelines, especially in regions that are hard-to-reach, prone to climate shocks and report the highest rates of malnutrition. Without renewed partner investment, Somalia risks reversing critical public health gains, increasing the likelihood of large-scale disease outbreaks and preventable deaths across the country.
Humanitarian access further deteriorated in 2025, particularly in Lower Juba, Gedo, Hiraan and Banadir, where conflict, inter-clan violence and administrative impediments have limited the delivery of health services. Armed clashes, road blockages and insecurity along main supply routes disrupted aid delivery and forced more than 20 health facilities to close following non-state armed group advances. In several districts, movement restrictions delayed the deployment of medical supplies and health personnel, and these access constraints continue to undermine WHO and partner operations.
Somalia’s Grade 3 emergency reflects the scale, complexity and sustained intensity of health needs, requiring system-wide surge, leadership and coordination. In 2025, nearly 6 million people required humanitarian and protection assistance, yet only 20% of the Humanitarian Response Plan (US$ 1.42 billion) was funded. Sustained investment will be critical to consolidate gains in epidemic control, maternal and child health and nutrition, and to prevent the further deterioration of health outcomes in 2026.