Somalia: Score Justification Summary

1.1.1a National plan for AMR priority pathogens

Score: 100

There is evidence that Somalia has a National AMR plan that covers surveillance, detection, and reporting of priority AMR pathogens.

The 'Somalia National Action Plan on combating antimicrobial resistance' published in November 2022 in collaboration with World Health Organization (WHO) under its Axis B contains as strategy plan with objectives along with activies and expected completion timelines with a focus to "organize the work in this axis and establish a platform of communication between the 3 sectors of the country", "extend capacity of existing national public health lab to become National PH Lab for AMR", and "build capacity of public and private hospital laboratories to detect AMR." (pg. 111).

The Action Plan acknowledges that the National public health lab has established a platform for detection of AMR in Mycobacterium tuberculosis via its 3 National reference labs, 1 in Mogadisho, 1 in Hargueza and 1 in Garawe. However, these labs deal mainly with AMR in Tuberculosis with some activity for AMR in Vibrio cholera and Malaria (pg. 14). Additionally, there is no standardized protocol that is agreed upon in all laboratories for the detection of antibiotic resistance. Under Axis B, the Action Plan includes a strategy for extending the capacity of existing national public health lab to become National Public Health Lab for AMR detection (pg. 137) as well as building capacity of public and private hospital laboratories to detect AMR. ¹

The Action Plan also calls for reporting to Global Antimicrobial Resistance and Use Surveillance System (GLASS) the data that is generated from the different hospitals in the AMR sentinel, and establish a platform for data pooling of the data generated from these labs on yearly basis, through an already appointed focal point ie. Dr,.Abrahman Hashi (pg. 116). ²

The WHO GLASS webpage confirms the enrollment of Somalia into the database in 2020, however no AMR surveillance data is available on the WHO webportal. ³

1.1.1b Capacity of national lab/lab system to test for AMR priority pathogens

Score: 50

The Republic of Somalia has designated laboratories with the capacity to detect all 7 + 1 priority pathogens at zonal level, however there is no evidence of a national laboratory with capacity to detect all 7+1 AMR pathogens .

According to the World Health Organisation (WHO) Joint External Evaluation of IHR Core Capacities (JEE), conducted 17 to 21 October 2016, Somalia has three human laboratories in Mogadishu, Bosaso (Puntland) and Hargeisa (Somaliland), which have the capacity to detect and report all seven priority AMR (antimicrobial resistant) pathogens (E. coli, K. pneumonia, S. aureus, S. pneumoniae, Salmonella spp., Shigella spp, N. gonorrheae) and Mycobacterium tuberculosis. For M. tuberculosis, microscopy and GeneXpert are the standard cultures, performed only in Somaliland. The National Public Health Reference Laboratory (NPHRL) and the Central Veterinary Research Laboratory are the designated referral labs for AMR in each zone. However, the JEE notes that capacity to detect AMR pathogens at the country level is not developed with the exception of a few larger hospitals, including Mogadishu Turkish Hospital. ⁴

The Somalia National Action Plan on Combating Antimicrobial Resistance (2022) acknowledges gaps in existing testing infrastucture and calls for building capacity of public and private hospital laboratories to detect AMR pathogens. ⁵

The 2025 Global antibiotic resistance surveillance report states that Somalia has not submitted any data to GLASS, and no data has been shared regarding National health infrastructure and its use. (pg. 88) ⁶

There is no relevant information on the Ministry of Agriculture and Irrigation of Somalia website ⁷ and the Ministry of Health and Human Services' website is inaccessible at the time of research. ⁸

1.1.1c National environmental surveillance for AMR residues/organisms

Score: 0

There is no evidence that the government of Somalia conducts detection or surveillance activities (e.g. in soil, waterways, etc.) for antimicrobial residues or AMR (antimicrobial resistant) organisms.

The 'Somalia National Action Plan on combating antimicrobial resistance' published in November 2022 in collaboration with World Health Organization (WHO) acknowledges that "antimicrobial resistant-microbes are found in people, animals, food, and the environment (in water, soil and air)" (pg. 8), however the Action Plan does not include surveillance activities of environmental pathways for AMR. ⁹

The World Health Organisation (WHO), Joint External Evaluation of IHR Core Capacities (JEE), of the Republic of Somalia, conducted 17 to 21 October 2016, makes no mention of any environmental surveillance of AMR residues or organisms by any entity including Somalia's Ministry of Environment. ¹⁰

No further evidence of AMR surveillance activities was found on the Ministry of Environment and Climate Change's website ¹¹ and the Ministry of Health and Human Services' website is inaccessible at the time of research. ¹²

1.1.2a National law(s) requiring prescription for antibiotic use (humans)

Score: 0

There is insufficient evidence that Somalia has national legislation or regulation in place requiring prescriptions for antibiotic use for humans.

According to the 'Somalia National Action Plan on combating antimicrobial resistance' published in November 2022 in collaboration with World Health Organization (WHO), under its Axis D (Antimicrobial Use Situation Analysis), "antibiotics are still a free commodity available for trade with almost no limitations, rules, regulations or quality control. High-end antimicrobials are sold to whomever can afford to buy them and can be prescribed by pharmacists, general practitioners, or even chosen by the consumer on an over the counter basis" (pg. 16). ¹³

The Somali National Medicines Policy published in October 2014 by the Ministry of Health and Human Services, under its Section 7 'Rational Use of Medicines' contains general guidelines for Prescribers on labelling and packaging requirements when dispensing medicines (pg. 20). However, the Policy does not make any reference specifically towards prescription of antibiotics for human use. ¹⁴

Somalia has an Interim National Medicines Regulatory Authority (INMRA) operating under the Ministry of Health and Human Services responsible for regulating and controlling medicines, biologics, medical devices, herbal medicines, food Supplements, tobacco, and medicated cosmetics. However, no regulations regarding requiring prescriptions for antibiotic use were found on the INMRA webportal. ¹⁵

At the time of research, the Ministry of Health and Human Services' website was inaccessible. ¹⁶

1.1.2b National law(s) requiring prescription for antibiotic use (animals)

Score: 0

There is insufficient evidence that Somalia has national legislation or regulation in place requiring prescriptions for antibiotic use for animals.

Somalia's Veterinary Law Code 2016 (Law Code No. 21) by the Ministry of Livestock, Forestry and Range under its Chapter 10 contains regulations on acquisition and distribution of veterinary drugs, as well as regulations for veterinary drug importers, distributors and sellers. However, no regulations specifically regarding prescriptions for antibiotic use for animals were found. ¹⁷

A 2024 review article in the scientific journal Heliyon confirms that "pharmacies and informal drug vendors (in Somalia) operate with minimal oversight, allowing antibiotics to be purchased without a prescription." ¹⁸

No further evidence of such regulations was found through the website of the Ministry of Livestock, Forestry and Range ¹⁹, and the Ministry of Health and Human Services' website was inaccessible at the time of research. ²⁰

1.2.1a Laws/plans on zoonotic disease

Score: 0

There is insufficient publicly available evidence that Somalia has national legislation, plans, or equivalent strategy documents for zoonotic disease prioritzation, detection and reporting.

The Country Cooperation Strategy for WHO and Somalia 2021–2025 under its strategies for increasing health security calls for "promoting the One Health approach for improving surveillance and response capacity at the animal-human interface for zoonotic diseases and health threats from antimicrobial resistance" (pg. 30). According to the Strategy, the measure of success for increased health security would be having a "national framework for One Health been implemented for surveillance and response to the threat of emerging zoonotic diseases and antimicrobial resistance and for enhanced coordination and collaboration between human health, environmental health and animal health sectors."(pg. 30). ²¹

According to a December 2023 research article published by One Health, following a multisectoral prioritization exercise using the One Health Zoonotic Disease Prioritization (OHZDP) tool, seven priority zoonoses were identified for Somalia: Rift Valley fever, Middle East respiratory syndrome, anthrax, trypanosomiasis, brucellosis, zoonotic enteric parasites (including Giardia and Cryptosporidium), and zoonotic influenza viruses. The research article makes no mention of a detection or reporting mechanism.²²

A February 2025 One Health assessment states that although Somalia has an Early Warning Alert and Response Network (EWARN) and other vertical surveillance systems in Somalia, it primarily reports only human-specific diseases and does not capture zoonotic diseases. ²³

1.2.1b Laws/plans on zoonotic disease spillover from animals to humans

Score: 0

There is no publicly available evidence that Somalia has a national legislation, plans or equivalent strategy document(s) which includes measures for risk identification and reduction for zoonotic disease spillover events from animals to humans.

No evidence of a legislation/plans nor measures for risk identification and reduction for zoonotic disease spillover events from animals to humans was found through the Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) ²⁴, website of National Institute of Health (NIH) Somalia ²⁵, Ministry of Livestock, Forestry and Range ²⁶, and the website of Somalia's Ministry of Health and Human Services was inaccessible at the time of research. ²⁷

1.2.1c Laws/plans for surveillance & control of multiple zoonotic pathogens

Score: 0

There is no publicly available evidence that Somalia has national legislation, plans, or guidelines that account for the surveillance and control of multiple zoonotic pathogens of public health concern.

A February 2025 One Health assessment states that although Somalia has an Early Warning Alert and Response Network (EWARN) and other vertical surveillance systems in Somalia, it primarily reports only human-specific diseases and does not capture zoonotic diseases. ²⁸

No further evidence was found through the Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) ²⁹, website of National Institute of Health (NIH) Somalia ³⁰, Ministry of Livestock, Forestry and Range ³¹, and the website of Somalia's Ministry of Health and Human Services was inaccessible at the time of research. ³²

1.2.1d Cross-ministerial department/agency/unit for zoonotic disease

Score: 0

There is insufficient public evidence that Somalia has a department, agency, or similar unit functioning as a multi-sectoral co-ordinating mechanism dedicated to zoonotic disease that functions across ministries.

According to the February 2025 One Health assessment, Somalia has a One Health National-Level Technical Working Group (OHNLTWG) comprising of representatives from the Ministries of Health, Livestock, Environment, and Agriculture. However the assessment states that "irregular meetings and lack of budget allocation hinder progress, resulting in a lack of tangible milestones in operationalizing OH practices nationwide"(pg. 6). Additionally, the Early Warning Alert and Response Network (EWARN) and other vertical surveillance systems in Somalia, primarily reports only human-specific diseases and does not capture zoonotic diseases. No evidence of a dedicated co-ordinating mechanism or agency/unit for to zoonotic disease that functions across ministries was found. ³³

According to the website of the Ministry of Livestock, Forestry and Range, the Department of Animal Health & Public Veterinary Services is responsible for "monitoring and detecting
animal diseases, both infectious and non-infectious, through effective surveillance systems". It further states that "the department ensures public health by preventing zoonotic diseases
and ensuring food safety". However, no evidence of a detailed implementation strategy nor a multi-sectoral co-ordinating mechanism was found on the Ministry's website. ³⁴

No further evidence was found through the Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) ³⁵, website of National Institute of Health (NIH) Somalia ³⁶, and the website of Somalia's Ministry of Health and Human Services was inaccessible at the time of research. ³⁷

1.2.1e Presence of One Health strategic plan

Score: 0

There is evidence that Somalia had a One Health Strategy for the 2017-2021 period, the Somalia OH Strategy 2017–2021. However, this document is not publicly available and research claims that the strategic plan does not incorporate the OH approach due to underrepresentation in other related ministries, which endorses linkages between human, animal, agriculture, and environmental sectors to achieve better health outcomes.³⁸ However, in February 2025, the government, as part of the Capacitating One Health in Eastern and Southern Africa programme (organised by the Organization of African, Caribbean and Pacific states (OACPS) with the financial support of the European Union), held the Visioning Workshop for Updating the One Health Strategic Plan (2025–2029). The next step from the session was to finalize the National One Health Strategic Plan (2025-2029) based on the discussions and inputs from the workshop.³⁹

1.2.2a Surveillance/reporting mechanism for zoonotic disease for livestock owners

Score: 0

There is no publicly available evidence that Somalia has a national mechanism (either voluntary or mandatory) for owners of livestock to conduct and report on disease surveillance to a central government agency.

Although the website of the Ministry of Livestock, Forestry and Range contains a webportal for 'Veterinary Export Health Certification System' ⁴⁰, the portal is not publicly accessible.

Department of Animal Health & Public Veterinary Services, operating under the Ministry is responsible for "monitoring and detecting animal diseases, both infectious and non-infectious, through effective surveillance systems". ⁴¹ No further evidence of a national mechanism (either voluntary or mandatory) for owners of livestock to conduct and report on disease surveillance was found on the Ministry's website. ⁴²

1.2.2b Laws/regulations on data confidentiality to protect livestock owners

Score: 0

There is no evidence that Somalia has there legislation and/or regulations that safeguard the confidentiality of information generated through surveillance activities for animals (for owners).

According to the website of the Ministry of Livestock, Forestry and Range, the Department of Animal Health & Public Veterinary Services is responsible for "monitoring and detecting animal diseases, both infectious and non-infectious, through effective surveillance systems" ⁴³. However, no evidence of regulations for confidentiality were found on the Ministry's website. ⁴⁴

No such provisions for confidentiality of information generated through surveillance activities for animals (for owners) were found in the Data Protection Act (Law No. 005 of 2023). ⁴⁵

1.2.2c Wildlife zoonotic disease surveillance

Score: 0

There is evidence that Somalia conduct surveillance of zoonotic disease in poultry and livestock, but not in wildlife.

According to the website of the Ministry of Livestock, Forestry and Range, the Department of Animal Health & Public Veterinary Services is responsible for "monitoring and detecting animal diseases, both infectious and non-infectious, through effective surveillance systems". It further states that the department ensures public health by preventing zoonotic diseases and ensuring food safety, and inspects food-producing animals and monitors animal-derived products. ⁴⁶ No evidence of zoonotic disease surveillance for wildlife was found on the Ministry's website. ⁴⁷

1.2.3a Annual reporting to OIE on zoonotic disease incidence

Score: 100

There is public evidence that Somalia has a mechanism for reporting notifiable diseases to The World Organisation for Animal Health (WOAH).

Somalia is a member of World Organisation for Animal Health (WOAH) with a delegate from the Department of Veterinary Services representing Somalia in the World Assembly. ⁴⁸

There is evidence of Somalia reporting notifiable diseases to the WOAH, with the most recent notification being sent in July 2023 for a disease outbreak of Echinococcus multilocularis. ⁴⁹

1.2.4a Number of veterinarians per 100,000 people

Score: 25.23

1.2.4b Number of veterinary para-professionals per 100,000 people

Score: 14.37

1.2.5a Inclusion of private sector in national plan/law on zoonotic disease

Score: 0

There is no publicly available evidence that Somalia has a national legislation, or plans include mechanisms for working with the private sector in controlling or responding to zoonoses.

No evidence of a legislation/plans nor measures for working with the private sector in controlling or responding to zoonoses was found through the Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) ⁵⁰, website of National Institute of Health (NIH) Somalia ⁵¹, Ministry of Livestock, Forestry and Range ⁵², and the website of Somalia's Ministry of Health and Human Services was inaccessible at the time of research. ⁵³

1.3.1a Updated national records of especially dangerous pathogen/toxin inventories

Score: 0

There is no publicly available evidence that Somalia has in place a record, updated within the past five years, of the facilities in which especially dangerous pathogens and toxins are stored or processed, including details on inventories and inventory management systems of those facilities.

No evidence of such a record was found through the websites of National Institute of Health (NIH) Somalia ⁵⁴, Somali Disaster Management Agency ⁵⁵, and the website of Somalia's Ministry of Health and Human Services was inaccessible at the time of research. ⁵⁶

1.3.1b Biosecurity laws on facility security for especially dangerous pathogens

Score: 0

There is no public evidence that Somalia has legislation and/or regulations related to biosecurity which address requirements such as physical containment, operation practices, failure reporting systems, and/or cybersecurity of facilities in which especially dangerous pathogens and toxins are stored or processed.

No evidence of such biosecurity legislation and/or regulations was found through the webportal of Federal Parliament of Somalia. ⁵⁷ No evidence of biosecurity regulations was found in the Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) ⁵⁸, Strategic Plan 2024 -2029 by the Somali Disaster Management Agency ⁵⁹, nor the website of National Institute of Health (NIH) Somalia. ⁶⁰ . According to the World Health Organisation (WHO), Joint External Evaluation of IHR Core Capacities of the Republic of Somalia (JEE), conducted 17 to 21 October 2016, "there is currently no national biosafety and biosecurity legislation, regulations or guidelines." The JEE also notes that the biosafety and biosecurity situation is so undeveloped that, "there was no opportunity to visit laboratories during the assessment. There was no biosafety and biosecurity related documentation available" (pg. 20-21). ⁶¹

1.3.1c Agency for enforcement of biosecurity laws/regulations

Score: 0

Somalia does not have biosecurity legislation and/or regulations, nor an agency for its enforcement.

No evidence of biosecurity legislation and/or regulations, nor an agency for its enforcement, was found through the webportal of Federal Parliament of Somalia. ⁶² No evidence of biosecurity regulations was found in the Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) ⁶³, Strategic Plan 2024 -2029 by the Somali Disaster Management Agency ⁶⁴, nor the website of National Institute of Health (NIH) Somalia. ⁶⁵

1.3.1d Consolidation of especially dangerous pathogens into minimum # of facilities

Score: 0

There is no public evidence that Somalia has taken action to consolidate its inventories of especially dangerous pathogens and toxins into a minimum number of facilities.

No evidence on consolidation of such inventories was found through the National Institute of Health (NIH) Somalia's website ⁶⁶, Facebook ⁶⁷ and X (formerly Twitter) ⁶⁸ pages of the Ministry of Health and Human Services; and the Ministry of Health and Human Services's website was inaccessible at the time of research. ⁶⁹

1.3.1e Capacity to conduct tests for anthrax/Ebola without culturing live pathogens

Score: 0

There is insufficient public evidence that Somalia has in-country capacity to conduct Polymerase Chain Reaction (PCR)–based diagnostic testing for anthrax and/or Ebola, which would preclude culturing a live pathogen.

According to a World Health Organisation (WHO) case study published in August 2023, "seven public health laboratories with real-time polymerase chain reaction (PCR) diagnostic technology and three out of these laboratories with next-generation sequencing technology" (pg. 4) have been established in Somalia. While the PCR technology was being used primarily for conducting COVID-19 genomic sequencing in 2023, capacity for using PCR–based diagnostic testing for anthrax and/or Ebola is unclear. ⁷⁰

No further evidence of PCR–based diagnostic testing for anthrax and/or Ebola was found through the National Institute of Health (NIH) Somalia's website ⁷¹; and the website of Ministry of Health and Human Services was inaccessible at the time of research. ⁷²

1.3.2a Biosecurity training using a standardised, required approach

Score: 0

There is no evidence that Somalia requires biosecurity training, using a standardized, required approach, such as through a common curriculum or a train-the-trainer program, for personnel working in facilities housing or working with especially dangerous pathogens, toxins, or biological materials with pandemic potential.

The World Health Organisation (WHO) Joint External Evaluation of IHR Core Capacities (JEE) of the Republic of Somalia, conducted 17 to 21 October 2016, does not note any existing training system. The JEE recommends that Somalia establish a multisectoral biosafety and biosecurity committee to develop legislation, "assess biosafety and biosecurity training needs and develop training material, and increase awareness of biosecurity and biosafety among the laboratory workforce" (pg. 21). ⁷³

There is no relevant information on the website of Ministry of Defence ⁷⁴, National Institute of Health (NIH) Somalia ⁷⁵, and the Ministry of Health and Human Services's website was inaccessible at the time of research. ⁷⁶ There are no relevant laws or regulations listed on the VERTIC Biological Weapons Convention Legislation Database. ⁷⁷

1.3.3a Personnel checks for permission to access to especially dangerous pathogens

Score: 0

There is no public evidence that Somalia has regulations or licensing conditions specify that security and other personnel with access to especially dangerous pathogens, toxins, or biological materials with pandemic potential are subject to the following checks: drug testing, background checks, and psychological or mental fitness checks.

No evidence of such regulations or licensing conditions was found through the webportal of Federal Parliament of Somalia. ⁷⁸ No evidence of biosecurity regulations was found in the Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) ⁷⁹, Strategic Plan 2024 -2029 by the Somali Disaster Management Agency ⁸⁰, nor the website of National Institute of Health (NIH) Somalia. ⁸¹ There are no relevant laws or regulations listed on the VERTIC Biological Weapons Convention Legislation Database. ⁸²

1.3.4a National transport regulations for Category A and B infectious substances

Score: 0

There is no publicly available evidence that Somalia has national regulations on the safe and secure transport of infectious substances (specifically including Categories A and B).

No evidence of such regulations was found through the he webportal of Federal Parliament of Somalia. ⁸³ No evidence of biosecurity regulations was found in the Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) ⁸⁴, Strategic Plan 2024 -2029 by the Somali Disaster Management Agency ⁸⁵, nor the website of National Institute of Health (NIH) Somalia. ⁸⁶ There are no relevant laws or regulations listed on the VERTIC Biological Weapons Convention Legislation Database ⁸⁷ nor in the Somali Pharmacovigilance Guideline. ⁸⁸

1.3.5a Laws/regulations on cross-border transfer and end-user screening

Score: 0

There is no public evidence that Somalia has a legislation and/or regulations in place to oversee the cross-border transfer and end-user screening of especially dangerous pathogens, toxins, and pathogens with pandemic potential.

In May 2024, the Ministry of Finance issued a revised 'General Customs Regulation (originally published in 2020), which, under its 'Part 4 Prohibited Imports and Exports' lays out regulations to establish clear guidelines on prohibited imports and exports to safeguard public health, safety, and security (pg. 7-10). However, no evidence of regulations for cross-border transfer and end-user screening of especially dangerous pathogens, toxins, and pathogens with pandemic potential was found. ⁸⁹

No further evidence of import/export restrictions on medical goods was found through the websites of Somalia Interim National Medicines Regulatory Authority (NMRA) ⁹⁰ and Ministry of Commerce and Industry. ⁹¹

1.4.1a Biosafety laws/regulations

Score: 0

Somalia does not have biosafety legislation and/or regulations in place.

No evidence of biosafety legislation and/or regulations was found through the webportal of Federal Parliament of Somalia. ⁹² No evidence of biosecurity regulations was found in the Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) ⁹³, Strategic Plan 2024 -2029 by the Somali Disaster Management Agency ⁹⁴, the website of National Institute of Health (NIH) Somalia ⁹⁵, nor the VERTIC database. ⁹⁶

1.4.1b Agency for enforcement of biosafety laws/regulations

Score: 0

Somalia does not have biosafety legislation and/or regulations, nor an agency for its enforcement.

No evidence of biosafety legislation and/or regulations, nor an agency for its enforcement, was found through the webportal of Federal Parliament of Somalia. ⁹⁷ No evidence of biosecurity regulations was found in the Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) ⁹⁸, Strategic Plan 2024 -2029 by the Somali Disaster Management Agency ⁹⁹, the website of National Institute of Health (NIH) Somalia ¹⁰⁰, nor the VERTIC database. ¹⁰¹

1.4.2a Biosafety training using a standardised, required approach

Score: 0

There is no evidence that Somalia requires biosafety training, using a standardized, required approach, such as through a common curriculum or a train-the-trainer program, for personnel working in facilities housing or working with especially dangerous pathogens, toxins, or biological materials with pandemic potential.

The World Health Organisation (WHO) Joint External Evaluation of IHR Core Capacities (JEE) of the Republic of Somalia, conducted 17 to 21 October 2016, does not note any existing training system. The JEE recommends that Somalia establish a multisectoral biosafety and biosecurity committee to develop legislation, "assess biosafety and biosecurity training needs and develop training material, and increase awareness of biosecurity and biosafety among the laboratory workforce" (pg. 21). ¹⁰²

There is no relevant information on the website of Ministry of Defence ¹⁰³, National Institute of Health (NIH) Somalia ¹⁰⁴, and the Ministry of Health and Human Services's website was inaccessible at the time of research. ¹⁰⁵

Somalia is a state signatory to the Biological Weapons Convention. State parties report to the United Nations Office at Geneva (UNOG) every year for the "Confidence Building Measure Return" (CBM), which is a reporting mechanism set by the Biological Weapons Convention. The reporting includes data on Biosafety Level (BSL) facilities, their level, location, floor area of the laboratory, types of pathogens stored and processed, the organizational structure of the facilities, etc. However, there is no evidence that Somalia has submitted a CBM report in the last two years or at all. ¹⁰⁶ There are no relevant laws or regulations listed on the VERTIC Biological Weapons Convention Legislation Database. ¹⁰⁷

1.5.1a Evidence of national assessment of dual-use research

Score: 0

There is no publicly available evidence that Somalia has conducted an assessment to determine whether ongoing research is occurring on especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research.

A September 2024 news report from Africa Centers for Disease Control and Prevention (CDC) states that Somalia is developing a laboratory strategic plan. The Plan is intented to be "tailored to the country’s needs, addresses gaps in lab infrastructure, sets priorities, and outlines strategies to improve diagnostics, train personnel, and ensure essential supplies". ¹⁰⁸ However, the Plan has not been released/publicly available at the time of research.

No further evidence of an assessment on especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research was found through the website of National Institute of Health (NIH) Somalia ¹⁰⁹, and the Ministry of Health and Human Services's website was inaccessible at the time of research. ¹¹⁰

1.5.1b National law/regulation on oversight of dual-use research

Score: 0

There is no publicly available evidence that Somalia has a legislation and/or regulation requiring oversight of research with especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research.

No evidence of such legislation and/or regulation was found through the Federal Parliament of Somalia ¹¹¹, Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) ¹¹², National Institute of Health (NIH) Somalia website ¹¹³, and the Ministry of Health and Human Services's website was inaccessible at the time of research. ¹¹⁴

1.5.1c Existence of agency responsible for oversight of dual-use research

Score: 0

There is no publicly available evidence that Somalia has an agency responsible for oversight of research with especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research.

The Somali Institute for Health Research (SIHR), according to its website has a dedicated research program for Communicable Diseases, with a focus on HIV, Tuberculosis, and STIs. In this context, the SIHR has worked on integration of pro-poor measures in TB and HIV control programmes, and developed guidances for national TB control programmes on the practical issues involved as well as actionable strategies. However, no evidence of research y SIHR on especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research was found. ¹¹⁵

No further evidence was found through the website of National Institute of Health (NIH) Somalia ¹¹⁶, and the Ministry of Health and Human Services's website was inaccessible at the time of research. ¹¹⁷

1.5.2a Requirement to screen synthesised DNA against list prior to sale

Score: 0

There is no publicly available evidence that Somalia has a legislation and/or regulation requiring the screening of synthesized DNA (deoxyribonucleic acid) against lists of known pathogens and toxins before it is sold.

No evidence of such legislation and/or regulation was found through the Federal Parliament of Somalia ¹¹⁸, Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) ¹¹⁹, National Institute of Health (NIH) Somalia website ¹²⁰, and the Ministry of Health and Human Services's website was inaccessible at the time of research. ¹²¹

1.6.1a Immunization rate for humans (measles/MCV2)

Score: 0

1.6.1b Availability of vaccination figures for livestock (FMD) through OIE database

Score: 0

Somalia's official foot-and-mouth disease (FMD) vaccination figures for livestock are not available through the OIE database.

The World Organisation for Animal Health (WOAH) WAHIS database on 'Surveillance and control measures' contains data on Somalia, with the most recently reported data on foot-and-mouth disease (FMD) being disease notifications and general surveillance updates from July 2025. ¹²² No data on vaccination figures for livestock FMD have been reported.

According to a 2018 presentation by the Director of Animal Health and Somalia's OIE Delegate, there has been a "total cessation of FMD surveillance activities in Somalia sinc 1991 and no vaccinations against FMD has taken place over the last 18 years". ¹²³
No recent evidence of vaccination for FMD in livestock was found through the website of Ministry of Agriculture and Irrigation. ¹²⁴

1.6.1c Equitablenature of national immunization strategy/plan

Score: 100

Somalia has a national immunization strategy/plan. The Comprehensive Multi Year Plan for Immunization System 2016-2020 developed by the Federal Government of Somalia. ¹²⁵ No evidence of a new/updated immunization strategy/plan was found through the National Institute of Health (NIH) Somalia's website ¹²⁶, and the website of Somalia's Ministry of Health and Human Services was inaccessible at the time of research. ¹²⁷

1.6.1d Vaccine hesitancy and build public trust coverage in vaccines in national immunization strategy/plans

Score: 100

Somalia has a national immunization strategy/plan. The outdated Comprehensive Multi Year Plan for Immunization System 2016-2020, released by the Government of Somalia in 2016, under its Strategic objective 2 specifically lists one of its key activities to focus on "training healthcare workers on effective communication techniques, especially to address vaccine hesitancy and to respond to reports of serious adverse events following immunization in order to maintain trust and allay fears." (pg. 82) ¹²⁸

1.6.1e National advisory group for immunization strategy/plan

Score: 100

There is public evidence that Somalia has a national advisory group that provides technical guidance and advice on the immunization strategy/plan to government.

According to a nomination document from February 2023, the Director General mistry of Health has established a National Immunization Technical Advisory Group (NITAG). The NITAG's function is to undertake the latest scientific advancements and recommendations, Situation analysis and assessment, as well Policy analysis and strategy formulation. The administrative function includes but not limited to proposing the list of NITAG members following the selection criteria, regular arrangement of the coordination meetings, and communication to the stakeholders to provide scientific recommendations to the immunization program. ¹²⁹

Additionally, according to the World Health Organisation's webportal, Somalia has an operational National Immunization Advisory Mechanism, with the latest data update from 2024. ¹³⁰

1.6.1f Presence of an immunization programme for influenza

Score: 0

There is no publicly available evidence that Somalia has an immunization programme for influenza.

No evidence of an immunization programme for influenza, nor availability of seasonal flu vaccines was found through the Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) ¹³¹, National Institute of Health (NIH) Somalia ¹³², and the website of Somalia's Ministry of Health and Human Services was inaccessible at the time of research. ¹³³

1.7.1a Strategy/plan for resilience of health system

Score: 100

There is evidence that Somalia has a plan to develop a strategy for its health system and it includes considerations that specifically address evolving threat of infectious diseases, changing weather patterns and acute events following extreme weather events.

The Somalia National Climate Change Policy, last updated by the Ministry of Environment and Climate Change in February 2023, acknowledges that Somalia has a heightened risk of climate-sensitive infectious illnesses such as foodborne, waterborne, vector-borne disease (pg. 22). Under its Section 3.2.5 'Impact on Health' states that Somalia will "endeavour to improve health status through establishing and upgrading health facilities, expanding community level nutritional program, institute early warning systems for drought and food insecurity, and improve water quality. In addition, doctors and nurses may need more training on how to deal with climate-related health problems, establish waste management systems, and promote public health awareness campaigns." ¹³⁴ Under Section 5.4.1, the Plan lists policies for the health sector, which include: improving data sharing and develop health information management systems for diseases including climate-sensitive diseases at all levels of the health delivery system; mapping disease incidence and identification of vulnerable groups for climate-sensitive diseases; and strengthening existing units within the health delivery system to manage climate-related epidemics (pg. 41-42). It also calls for strengthen surveillance programmes for monitoring human health under a changing climate, particularly operational knowledge on climate-disease relationships. ¹³⁵

The National Transformation Plan (2025–2029) developed by the Ministry of Planning, Investment and Economic Development under its Pillar 4 'Environment and Climate Resilience' focuses to restore ecosystems, enhance food security, and create sustainable livelihoods, ensuring that Somalia’s most affected populations can withstand future climate-related shocks. (pg. 388-390) However, the Plan does not cover threat of infectious diseases due to climate change. ¹³⁶

The Strategic Plan 2024 -2029 released by the Somali Disaster Management Agency ( SoDMA) in December 2023 acknowledges that recent climate change impacts have led to an increased frequency of extreme weather events such as famine, drought and floods, which have led to an increase in natural disasters (pg. 5). Under its Thematic Area 6: 'Focus on Disaster Prevention Strategies', it calls for "integrating climate change considerations into disaster management plans, developing adaptive strategies to address changing weather patterns." (pg. 32). The Plan further includes strategies for Developing tools and SoDMA programs for climate change in disaster settings. ¹³⁷ However, the Plan's strategies do not specifically address the threat of infectious diseases.

The current Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) makes no mention of considerations to address the threat of infectious diseases due to climate change. ¹³⁸

2.1.1a Capacity of national lab system to conduct 5 or more WHO core tests

Score: 0

There is insufficient evidence that Somalia has a national laboratory system have the capacity to conduct diagnostic tests for at least 5 of the 10 WHO-defined core tests.

According to the World Health Organisation (WHO) Joint External Evaluation of IHR Core Capacities (JEE) of the Republic of Somalia, 17 to 21 October 2016, "the national laboratory system is capable of conducting 4 core tests. Reference laboratories can conduct four core tests identified by the International health regulations (IHR): serology for HIV, microscopy for M. tuberculosis, rapid diagnostic testing for Plasmodium and bacterial culture for Salmonella enteriditis serotype Typhi. (pg. 26). ¹³⁹

No further evidence of diagnostic capabilities was found through the webpage of Public Health Laboratory Services, operating under the National Institute of Somalia. ¹⁴⁰

2.1.1b Plan to conduct testing during a public health emergency

Score: 0

There is insufficient public evidence that Somalia has a national plan, strategy or similar document for conducting testing during a public health emergency, which includes considerations for testing for novel pathogens, scaling capacity, and defining goals for testing.

One of the goals of the National Institute of Somalia's Public Health Laboratory Services is to "strengthen laboratory capacity for referral and backup testing services that support clinical care, public health surveillance and outbreak response." ¹⁴¹ However the NIH website does not contain further information on testing for novel pathogens, scaling capacity, or defined goals for testing. ¹⁴²

No further evidence of a national plan/strategy for the above was found through the Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) ¹⁴³, Somali Disaster Management Agency's Strategic Plan ¹⁴⁴; and the website of Somalia's Ministry of Health and Human Services was inaccessible at the time of research. ¹⁴⁵

2.1.2a Existence of an accredited national lab serving as a reference facility

Score: 0

There is no public evidence that Somalia has a national laboratory that serves as a reference facility which is accredited.

The National Institute of Health (NIH) Somalia's webpage for 'Public Health Laboratory Services' states that one of its objectives is "supporting laboratories to work towards accreditation by providing technical assistance, quality assurance, and equipment maintenance."¹⁴⁶

A July 2020 news report by the World Health Organisation states that Somalia has developed a PCR laboratory and "can now strive to receive international accreditation.” ¹⁴⁷

However, no evidence of an accredited laboratory was found through the NIH website ¹⁴⁸, nor official Facebook ¹⁴⁹ and X (formerly Twitter) ¹⁵⁰ pages of the Ministry of Health and Human Services.

2.1.2b External quality assurance of a national lab serving as a reference facility

Score: 0

There is evidence of a national laboratory that serves as a reference facility in Somalia, however there is no evidence that it is subject to external quality assurance review.

According to a World Health Organisation update from 2020, Somalia’s National Public Health Reference Laboratory (NPHRL), located in Mogadishu serves as the national laboratory that serves as a reference facility. ¹⁵¹

The Public Health Laboratory Services under National Institute of Health (NIH) Somalia, on its webpage states that its aim is "establishing a quality laboratory system and building the capacity of national and regional clinical and public health reference laboratories". However, no mention of an external quality assurance review was found. ¹⁵²

2.2.1a Nationwide specimen transport system

Score: 0

There is insufficient evidence that Somalia has a nationwide specimen transport system.

According to a 2022 World Health Organisation (WHO) assessment of Somalia’s health information system, Somalia needs to ncrease its Laboratory support by "integrating and expanding sample transportation system to serve sample collection and transportation for all priority diseases" (pg.39). ¹⁵³

According to the World Health Organisation (WHO) Joint External Evaluation of IHR Core Capacities (JEE) of the Republic of Somalia, 17 to 21 October 2016, "a system is in place to transport specimens to national laboratories from less than 50% of intermediate level/districts for advanced diagnostics (pg. 26). ¹⁵⁴

No further evidence of a nationwide specimen transport system was found through the Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) ¹⁵⁵, National Institute of Health (NIH) Somalia's website ¹⁵⁶; and the the website of Somalia's Ministry of Health and Human Services ¹⁵⁷ was inaccessible at the time of research.

2.2.2a Plan to rapidly authorize/license laboratories to scale-up testing during an outbreak

Score: 0

There is no publicly available evidence that Somalia has a plan in place to rapidly authorize or license laboratories to supplement the capacity of the national public health laboratory system to scale-up testing during an outbreak.

According to a document released by the Ministry of Health and Human Services in 2020 on the Purpose of National Health Professionals Council, the Council is responsible for licensing and accrediting public and private health facilities, and health services (pg. 6). ¹⁵⁸ However, there is no mention of a mechanism to rapidly authorize or license laboratories during an outbreak.

The Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) developed by the Ministry of Health and Human Services, under its Annex B calls for "accreditation of training institutions and certification (or licensing) of health workers" to boost health care access and demand through both public and private healthcare providers. However, the HSSP III makes no reference to a plan/mechanism to rapidly authorize or license laboratories during an outbreak, or in general. ¹⁵⁹

According to a news update by Africa Centers for Disease Control and Prevention (CDC) from September 2024, Somalia’s Federal Ministry of Health and Human Services, with support from Africa CDC is developing a 'laboratory strategy plan'. This Plan is expected to align with global standards such as the International Health Regulations (IHR 2005) as well as "address gaps in lab infrastructure, sets priorities, and outlines strategies to improve diagnostics, train personnel, and ensure essential supplies". ¹⁶⁰ However the Plan is not yet released.

No further evidence of a plan to rapidly authorize or license laboratories was found through the Public Health Laboratory Services webpage of National Institute of Health (NIH) Somalia. ¹⁶¹

2.3.1a Evidence of ongoing event-based and indicator-based surveillance and analysis

Score: 50

There is public evidence that Somalia is conducting ongoing event-based and indicator-based surveillance and analysis for notifiable and novel infectious disease, however there is no evidence of data being analyzed on a daily basis.

According to a October 2021 policy brief by the World Health Organisation (WHO), Somalia has adopted the Integrated Disease Surveillance and Response Strategy (IDSR), which aims to "develop sufficient surveillance and response capacities at each level of the national health system and effectively link efficient public health action with all available data – information from multiple surveillance and response systems as well as laboratory evidence". ¹⁶²

As per a June 2024 news update by the World Health Organisation (WHO), the Integrated Disease Surveillance and Response Unit, under the Ministry of Health and Human Services has by the end of 2023, these health facilities had submitted reports on 42 priority conditions. From epidemiological week 3 to week 13 of 2024, this number increased to 409. Of the health facilites that have received the training, 80% have been regularly submitting surveillance data. Additionally, according to the update, Somalia has also initiated steps to implement event-based surveillance, especially at the community level, to complement the IDSR system. ¹⁶³ However, there is no evidence that the data is being analyzed on a daily basis.

According to a 'Comprehensive assessment of Somalia’s health information system' published by the WHO in 2022 "data are shared on a weekly basis with the surveillance focal points at the district level (HMIS focal point) who then enter the data tothe IDSR data set on DHIS2" (pg. 15). ¹⁶⁴

2.3.1b Evidence of a mechanism (such as IHR focal point) for reporting notifiable diseases to the WHO within the set timeline

Score: 100

There is publicly available evidence of a mechanism (such as IHR focal point) for reporting notifiable diseases to the WHO within the set timeline

National Institute of Health (NIH) Somalia, according to its webpage on 'Capacity-Building Development Plan, is the designated International Health Regulation Focal Point (IHRFP) for Somalia, and a State Party to the International Health Regulations (IHR) 2005. The IHR is a legally binding agreement of 196 countries to prevent, protect against, control and respond to public health emergencies of international concern. As the IHRFP, NIH coordinates and facilitates the implementation of the IHR 2005 and the National Action Plan for Health Security (NAPHS) in Somalia. ¹⁶⁵

2.3.2a Electronic national and sub-national reporting surveillance system

Score: 100

There is evidence that Somalia operates electronic surveillance and reporting systems at the national and sub-national levels.

The Ministry of Health & Human Services has adopted DHIS2 as the national Health Management Information System (HMIS) platform, which includes electronic Integrated Disease Surveillance and Response (e-IDSR) modules for case-based and weekly reporting. According to the MoH Quarterly Health Statistics Bulletin (2023), DHIS2 is used to capture “individual level data (tracker) case-based information such as e-IDSR,” and the system aggregates data from hundreds of health facilities across multiple regions (pg. 5). ¹⁶⁶

In addition, Somalia has historically used the Early Warning Alert and Response Network (EWARN) since 2008 for electronic reporting of epidemic-prone diseases, and is now transitioning to a unified electronic IDSR (e-IDSR) platform integrated with DHIS2. WHO Somalia reports that, by the end of 2023, these health facilities had submitted reports on 42 priority conditions, as well as "weekly epidemiological bulletins with analysis and trends of various conditions". ¹⁶⁷

2.3.2b Collection of ongoing/real-time lab data by electronic surveillance system

Score: 50

There is public evidence of an electronic reporting surveillance system in Somalia to collect ongoing or real-time laboratory data, however there is no evidence of data being disaggregated and analysed by age, ethnicity, etc.

A 2022 assessment of Somalia’s health information systems by World Health Organisation (WHO) notes the absence of a "supportive supervision checklist integrated into DHIS2 to enable real time data entry" (pg. 8). Additionally, the assessment states that "Disaggregated demographic estimates not available at state level" and "equity analyses (disaggregation by gender and geography) are not conducted, though there is potential to conduct them using DHIS2" (pg. 8). ¹⁶⁸

The most recently available Quarterly Health Statistics Bulletin released by the Ministry of Health & Human Services in July 2023 states that the Ministry of Health, with support from its partners, has developed an electronic IDSR system, incorporating case-based data collection. The Electronic Integrated Disease Surveillance and Response (e-IDSR) System is a digital platform for "disease monitoring and reporting at all levels". It enables "real-time data collection, analysis, and sharing to swiftly identify and respond to health threats" (pg. 2). ¹⁶⁹ No evidence of e-IDSR's collected data being disaggregated and analysed by age, ethnicity, etc. was found in the bulletin¹⁷⁰

2.3.3a National wastewater surveillance programme or initiative

Score: 50

There is evidence of some wastewater and environmental surveillance (WES) activity within the country. The WHO EMR Polio Bulletin from May 2026 documents positive environmental samples from the country in 2026.¹⁷¹

According to the WHO, Environmental surveillance system was first established in Mogadishu in 2017 and has been expanded every year to the current 16 sites that are operational across the country.¹⁷²

Environmental surveillance (ES) for poliovirus in Somalia is conducted via systematic sewage sampling at 17 sites in 11 administrative regions in six states. During January 2017-March 2024, a total of 73 cVDPV2 isolates were detected across four of the six states with ES sites; Banadir state accounted for 66 (90%) detections. Collection sites in Somalia increased from four in 2017 to 17 in 2023.¹⁷³

There is evidence of past wastewater surveillance programmes in the country. In 2019, environmental surveillance teams with the Global Polio Eradication Initiative in Mogadishu accessed the underground closed drainage system to collect sewage waste water samples, which they packaged and sent to the laboratory for testing, aiming to identify whether poliovirus is present or not.¹⁷⁴

2.4.1a Common usage of electronic health records

Score: 50

There is evidence of electronic health records being used in Somalia, however they are not commonly in use.

According to a 2024 research article titled 'Electronics in Healthcare: Adaptation and Challenges of Digital Records in Somali Hospitals', 63% of surveyed hospitals have implemented Electronic Health Records (EHR) systems. However, the research article also notes that there are "considerable barriers, including technical issues, financial constraints, and a lack of technical expertise, which impede the full integration and effective use of EHR systems". ¹⁷⁵

A Comprehensive assessment of Somalia’s health information system published by the World Health Organisation (WHO) in 2022 states that "routine information systems are largely paper-based" (pg. 5) and "unified paper-based registers are used in all health facilities" (pg. 15). It further states that fragmentation is prevalent in public hospitals where "a combination of paper, Excel and DHIS2 is used to record data and no uniform information management system is in place for data management" (pg. 17).¹⁷⁶

2.4.1b Public health system access to individual electronic health records

Score: 0

The national public health system does not have access to electronic health records of individuals at the national level. According to the WHO’s Comprehensive Assessment of Somalia’s Health Information System (2022), routine health information systems in Somalia are ‘largely paper-based,’ with ‘unified paper-based registers… used in all health facilities,’ and public hospitals relying on a fragmented combination of paper, Excel, and DHIS2, with ‘no uniform information management system’ in place (pp. 5, 15, 17) ¹⁷⁷. Although the Ministry of Health has initiated pilot electronic health records implementations in only two facilities in Banadir, integrated with DHIS2 and supported by Sweden, these remain limited in scope and are not yet deployed nationally (WHO Update on IDSR Implementation in Somalia, 2023, p. 2). Therefore, Somalia does not have a national system through which public health authorities can access individual-level electronic health records ¹⁷⁸.

2.4.1c Existence of data standards for health record data comparability

Score: 0

There is insufficient evidence that Somalia has data standards to ensure data is comparable (e.g., ISO standards).

The Health Information System Statistical Plan (HISSP) developed by the Ministry of Health and Human Services in 2018, calls for creation of a harmonized framework for health information system development (theHMN framework) which will work with countries to define essential healthinformation platform designs, key health information standards, data and analyticcapacities, and guidelines for information use that drive country-level HISdevelopment and local/regional/global access and comparability (pg. 5). It further states that it is committed to producing quality products conforming to the keycomponents of accuracy, timeliness, methodological soundness,interpretability, coherence and comparability, accessibility, completeness, reliability and relevance (pg. 19). ¹⁷⁹

A Comprehensive assessment of Somalia’s health information system published by the World Health Organisation (WHO) in 2022 confirms that "standard operating procedures (SOPs) for Health Management Information System (HMIS) exist" (pg. 8). ¹⁸⁰ However it also highlights the challenges faced by Somalia’s Ministry of Health in obtaining reliable, up to date and comparable health data, and outlines opportunities for health information system strengthening. According to the assessment, addressing challenges will require "building on the capacities of other institutions and partners and consolidating multiple data workstreams into a comprehensive national system" (pg. 5). ¹⁸¹

2.4.2a Data sharing mechanisms

Score: 0

There is insufficient evidence that Somalia has an established mechanisms at the relevant ministries responsible for animal, human, and wildlife surveillance to share data.

According to a One Health article published in December 2023, "each sector conducts surveillance, but cross-sectoral data-sharing mechanisms and combined planning are absent. Allied agencies have separate chains of command, making collaboration across sectors impossible".¹⁸²

A One Health National Bridging Workshopthe Federal Republic of Somalia conducted from 13-15 November 2023. The workshop's output included a strategy for linking all current data based to IDSR for One Healthsystem for real time data sharing and analysis platforms (pg 23), in order to develop an intersectoral information sharing mechanisms through One Health approach. ¹⁸³

No further evidence of a mechanism for sharing animal, human, and wildlife surveillance data was found via the website of National Institute of Health (NIH) Somalia ¹⁸⁴, Ministry of Livestock Forestry & Range ¹⁸⁵, and the Ministry of Health and Human Services's website was inaccessible at the time of research. ¹⁸⁶

2.4.3a Availability of de-identified health surveillance data on disease outbreaks

Score: 100

There is publicly available evidence that Somalia make de-identified health surveillance data on infectious diseases publicly available via reports on non-governmental websites.

Weekly Epidemiological Bulletins are published on the World Health Organization (WHO) webportal by the Federal Ministry of Health and WHO. ¹⁸⁷ The most recently published EPI Watch bulletin for Week 36-37 of 2023 (4-17 September 2023) includes data on suspected cholera cases (14,626 cases from Week 1-43) and children under five (8,883, 53.7%) in drought- and flood-affected districts. ¹⁸⁸

Additionally, weekly e-IDSR Epidemiological Bulletins are published on United Nations Office for the Coordination of Humanitarian Affairs (OCHA) webportal. The most recent bulletin is available for the Epidemiological-Week 47 (18th – 24th November 2024). ¹⁸⁹

The most recently available “Quarterly Health Statistics Bulletin” published by the Ministry of Health & Human Services for July-September 2023, includes surveillance-data summaries of infectious diseases (e.g., suspected cholera, measles, SARI) by epidemiological week, age group, sex, region, and number of reporting facilities. ¹⁹⁰

No evidence of current health surveillance data on infectious diseases was found on the website of the National Institute of Health (NIH) Somalia ¹⁹¹, and the Ministry of Health and Human Services's website was inaccessible at the time of research. ¹⁹²

2.4.4a Confidentiality legislation/regulations for identifiable health information

Score: 0

There is insufficient evidence that Somalia has regulations that safeguard the confidentiality of identifiable health information for individuals, such as that generated through health surveillance activities.

The Standard Operating Procedures (SOP) published by the Ministry of Health and Human Services in February 2022 for the Health Management Information System (HMIS) – later incorporated into DHIS2, states that "data should be collected, recorded, and managed in accordance with the Ministry of Health policies to protect patient confidentiality."(pg. 5). Under its Section 2.2, it contains regulations on data protection, stating that "Data containing patient names (Registers / Tracker App) should not be transmitted in a way that could allow unauthorized interception." Additionally, all staff accessing medical data shall be made aware of their responsibility to maintain patient confidentiality, as well as, is required to undertake an initial training prior to assignment and regular refresher trainings on data ethics especially with regards to the handling of patient data (pg. 6-7). ¹⁹³

The Data Protection Act (2023) categorises 'health status' data as 'sensitive personal data' and it is therefore to be safeguarded as per the Act. However the Act does not contain specific legislations for health data nor specific protection of confidentiality for identifiable health information. ¹⁹⁴

2.4.4b Inclusion of cyber protections in health data confidentiality law/regulation

Score: 0

There is insufficient public evidence that Somalia has regulations safeguarding the confidentiality of identifiable health information for individuals, such as that generated through health surveillance activities, include mention of protections from cyber attacks.

The Standard Operating Procedures (SOP) published by the Ministry of Health and Human Services in February 2022 for the Health Management Information System (HMIS) – later incorporated into DHIS2 contains ontains detailed security regulations for both Non-Electronic Data and electronic data generated through HMIS and DHIS2. Under Section 2.3 titled 'Data Security, the SOP contains regulations for making data stating that "Data for analysis should be anonymized and contain only minimum personal identifiers necessary for analysis such as age, sex, and geographic location. Patient names, DOB, mobile phone numbers, etc. should never appear in the summary tools or reports of analyzed data." It further explicitly states that "computers used to enter or access data should have updated anti-virus software to safeguard against data corruption and phishing"(pg. 7). ¹⁹⁵

The Data Protection Act (2023) categorises 'health status' data as 'sensitive personal data' and it is therefore to be safeguarded as per the Act. However the Act does not contain specific legislations for health data nor specific protection of confidentiality for identifiable health information. ¹⁹⁶

2.4.5a Cooperative commitments or agreements within regions

Score: 100

There is public evidence that Somalia has made a commitment via public statements and/or a cooperative agreement to share surveillance data during a public health emergency with other countries for more than one disease.

In 2019, Somalia signed a Memorandum of understanding (MOU) with Ethiopia on 'Cross-border Cooperation and Coordination on Animal Health and Sanitary Measures'in response to the threat of transboundary animal diseases including Foot-and-mouth Disease, Contagious Bovine Pleuropneumonia, Peste des Petit Ruminates, Contagious Caprine Pleuropneumonia, Sheep and Goat Pox, Rift Valley fever, Rabies, Lumpy skin disease, Camelpox, Haemorrhagic Septicaemia and brucellosis. ¹⁹⁷ According to the MOU, the Parties shall "cooperate in the harmonizing Trans-boundary Animal Diseases (TADs) prevention and control approach through joint surveillance, information sharing and disease control initiatives. ¹⁹⁸

In 2018, Somalia conducted a Joint Cross-Border Health Coordination with Kenya , which resulted in the strengthening of the cross-border health initiative framework for sharing information on disease surveillance at the local level among border districts in Kenya and Somalia.The meeting report indicates establishment of surveillance data sharing for Acute Flaccid Paralysis (AFP) and strengthening of Polio data, along with "other diseases conditions/events among border district/health facilities". ¹⁹⁹

The country's adherence to the International Health Regulations (IHR 2005) serves as a primary legal and operational commitment. As a signatory, Somalia is obligated to notify the World Health Organization (WHO) of public health events that may constitute a public health emergency of international concern. However it is important to note that while this legally binding framework necessitates the sharing of surveillance data with the WHO, it does not specify provisions to share with other countries. ²⁰⁰

2.5.1a National support to conduct contact tracing in the event of a public health emergency

Score: 0

There is no publicly available evidence that Somalia has a national system in place to provide support at the sub-national level (e.g. training, metrics standardization and/or financial resources) to conduct contact tracing in the event of a public health emergency.

No evidence of a system or training, metrics standardization and/or financial resources to conduct contact tracing was found through the Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) ²⁰¹, Somali Disaster Management Agency's Strategic Plan ²⁰², National Institute of Health (NIH) Somalia website ²⁰³; and the website of Ministry of Health and Human Services was inaccessible at the time of research. ²⁰⁴

2.5.1b Provision of wraparound services to enable self-isolation/quarantine as recommended

Score: 0

There is insufficient publicly available evidence that Somalia provides wraparound services to enable infected people and their contacts to self-isolate or quarantine as recommended, particularly economic support (paycheck, job security) and medical attention.

A June 2021 poilcy paper by the National Economic Council (NEC) of Somalia states that the government has used "fiscal measures and direct incomes support to those affected by the COVID-19 virus. The types of support have included income and credit subsidies and tax breaks for individuals and companies, especially to SMEs; price support for consumers; and material support in the form of food and other necessities to the most vulnerable members of the society" (pg. 34). However, no evidence of wraparound services specifically for self-isolation or quarantining were found. ²⁰⁵

No evidence of provisions such as wraparound services for infected people and their contacts to self-isolate or quarantine were found through the Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) ²⁰⁶ Somali Disaster Management Agency's Strategic Plan ²⁰⁷, National Institute of Health (NIH) Somalia website ²⁰⁸; and the website of Ministry of Health and Human Services was inaccessible at the time of research. ²⁰⁹

2.5.2a Strategy for tracing and quarantining international travelers

Score: 0

There is insufficient evidence that Somalia has a joint plan or cooperative agreement between the public health system and border control authorities to identify suspected and potential cases in international travelers and trace and quarantine their contacts in the event of a public health emergency.

The webpage on 'Immigration and Border Management' by the International Organization for Migration (IOM) Somalia states that the IOM assists "relevant national entities and frontline officials in enhancing inter-agency and cross-border coordination on COVID-19 preparedness and response, as well as facilitating access to emergency healthcare for migrants". ²¹⁰ However, no plan or details of a mechanism were found on the IOM Somalia website.

No further evidence of a joint plan or cooperative agreement between the public health system and border control authorities to identify suspected and potential cases in international travelers and trace and quarantine their contacts in the event of a public health emergency was found through the websites of Immigration and Citizenship Agency (ICA) ²¹¹, Immigration and Border Control Department ²¹²; and the website of Ministry of Health and Human Services was inaccessible at the time of research. ²¹³

2.6.1a Access to field epidemiology training program in country and/or abroad

Score: 100

There is evidence that Somalia has applied epidemiology training program (such as FETP) available in country, and resources are being provided by the government to send citizens to another country to participate in FETPs.

According to the Capacity-Building Development Plan published on National Institute of Health (NIH) Somalia's website, the NIH is focussed on Field Epidemiology Capacity Development. The first Frontline-FETP in Somalia was inaugurated on 29th August 2021. According to the website, the Frontline-FETP targets public health professionals and surveillance/IDSR officers at national, state, regional, and district levels. It provides short training to enhance the epidemiological skills of health professionals and services. ²¹⁴ As of November 2023, second workshop of the fifth cohort of the Field Epidemiology Training Program (FETP-P) had commenced. ²¹⁵

According to the World Health Organisation (WHO) Joint External Evaluation of IHR Core Capacities (JEE) of the Republic of Somalia, 17 to 21 October 2016, "Somalia has access to the field epidemiology training programme (FETP) in Kenya and Somali veterinarians should be trained through this programme." (pg. 16) ²¹⁶

No evidence of resources being provided by the government to send citizens to another country to participate in applied epidemiology training programs (such as FETP) was found through the website of National Institute of Health (NIH) Somalia ²¹⁷, and the Ministry of Health and Human Services was inaccessible at the time of research. ²¹⁸

2.6.1b Existence of field epidemiology training for animal health professionals

Score: 0

There is no public evidence that Somalia has field epidemiology training programs explicitly inclusive of animal health professionals, and there is no specific animal health field epidemiology training program offered (such as FETPV).

According to the Capacity-Building Development Plan published on National Institute of Health (NIH) Somalia's website, the NIH provides Field Epidemiology training programmes; however these training programmes are not explcitly inclusive of animal health professionals nor is there a specific animal health field epidemiology training program offered (such as FETPV). ²¹⁹

According to the World Health Organisation (WHO) Joint External Evaluation of IHR Core Capacities (JEE) of the Republic of Somalia, 17 to 21 October 2016, in the context of zoonotic diseases states that, "Somalia has access to the field epidemiology training programme (FETP) in Kenya and Somali veterinarians should be trained through this programme." (pg. 16). ²²⁰ However, the report also states that although "several people have been trained in (these) field epidemiology type training programmes but there is no registry of them and no existing or planned programme for the country." (pg. 2). ²²¹

No further evidence of a specific animal health field epidemiology training program being offered (such as FETPV) was found through the Somalia Field of Epidemiology Training Program website ²²², and the Ministry of Health and Human Services was inaccessible at the time of research. ²²³

2.6.2a Evidence of at least 1 trained field epidemiologist per 200,000 people

Score: 100

There is public evidence that Somalia has at least 1 trained field epidemiologist per 200,000 people.

According to a February 2024 news report published by the African Field Epidemiology Network on its website, with the completion of the 5th cohort of the Frontline-Field Epidemiology training programme, a total of 123 persons have completed the Frontline-Field Epidemiology training programme. ²²⁴

The population of Somalia, as reported by World Bank, as of 2024 is 19,009,151 ²²⁵ Therefore Somalia has ~1.29 trained field epidemiologist per 200,000 people.

3.1.1a National emergency response plan for diseases with pandemic potential

Score: 33.33

There is evidence that Somalia has Disease-specific plans in place, but there is no evidence of an overarching national public health emergency response plan.

According to an April 2024 press release by United Nations Children's Fund (UNICEF), Somalia’s Ministery of Health and Human Services has launched the 'Somalia Emergency Action Plan (SEAP) 3' , which prioritizes robust, high-quality polio vaccination campaigns and better poliovirus surveillance. The SEAP is also targeted at high-risk populations in hard-to-reach areas and where variant poliovirus is circulating, as well as underserved, displaced and nomadic communities. ²²⁶ The SEAP could not be retrieved as the Ministry of Health and Human Services's website was inaccessible at the time of research. ²²⁷

In 2020, the 'Somalia COVID-19 Country Preparedness and Response Plan (CPRP) was launched by United Nation's agencies and cluster partners, including NGOs, to respond to the direct public healthand indirect immediate humanitarian (component 1) and socio-economic (component 2) consequences of COVID-19 in Somalia. The plan is aligned and includes support to key interventions within the Federal Government of Somalia’s Comprehensive Socio-Economic Impact and Response Plan for Covid-19, launched on 27 March 2020. ²²⁸

No evidence of an overarching national public health emergency response plan was found through the website of Ministry of Health and Human Services. ²²⁹ Although the Somali National Institute of Health (NIH), a semi-autonomous national public health institution under the Ministry of Health and Human Services (MOH&HS) has a Public Health Emergency Operations Center; no evidence of a strategy/plan was found on their website. ²³⁰

3.1.1b National public health emergency response plan published in past 3 years

Score: 0

There is no evidence of an overarching national public health emergency response plan in Somalia.

Although the Somali National Institute of Health (NIH), a semi-autonomous national public health institution under the Ministry of Health and Human Services (MOH&HS) has a Public Health Emergency Operations Center; no evidence of a strategy/plan was found on their website. ²³¹ The Ministry of Health and Human Services's website was inaccessible at the time of research. ²³²

3.1.1c One health principles by covering multiple threat types

Score: 0

There is no evidence of an overarching national public health emergency response plan in Somalia.

Although the Somali National Institute of Health (NIH), a semi-autonomous national public health institution under the Ministry of Health and Human Services (MOH&HS) has a Public Health Emergency Operations Center; no evidence of a strategy/plan was found on their website. ²³³ The Ministry of Health and Human Services's website was inaccessible at the time of research. ²³⁴

3.1.1d Vulnerable populations in national public health emergency response plan

Score: 0

There is no evidence of an overarching national public health emergency response plan in Somalia.

Although the Somali National Institute of Health (NIH), a semi-autonomous national public health institution under the Ministry of Health and Human Services (MOH&HS) has a Public Health Emergency Operations Center; no evidence of a strategy/plan was found on their website. ²³⁵ The Ministry of Health and Human Services's website was inaccessible at the time of research. ²³⁶

3.1.2a Mechanism to engage private sector in outbreak preparedness/response

Score: 0

There is no publicly available evidence that Somalia has a specific mechanism(s) for engaging with the private sector to assist with outbreak emergency preparedness and response.

The Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) developed by the Ministry of Health and Human Services acknowleges that "the important issue for the health sector, in terms
of strategy, is how to engage private providers and ensure that EPHS services are offered at all facilities, specifically for secondary care to deliver quality services" (pg. 13). However, no evidence of a dedicated mechanism for engaging with the private sector to assist with outbreak emergency preparedness and response was found in the HSSP III. ²³⁷

No further evidence of such a mechanism was found through the Somali National Institute of Health's website ²³⁸, and the website of the Ministry of Health and Human Services was inaccessible at the time of research. ²³⁹

3.1.3a Policy/plan/guidelines in place to implement non-pharmaceutical interventions (NPIs)

Score: 50

There is evidence that Somalia has a policy, plan or guidance in place to implement non-pharmaceutical interventions during an epidemic or pandemic, however they exist for only one disease.

In 2020, the Ministry of Health and Human Services in line with the National Contingency Plan for Preparedness and Response to Coronavirus Disease 2019, implemented certain non-pharmaceutical interventions in form of restrictions such as mandatory use of facemasks in public areas, prohibition of mass gatherings and closure of schools, and religiuous places. ²⁴⁰

No further evidence of a policy/plan/guidelines to implement non-pharmaceutical interventions (NPIs) during an epidemic or pandemic was found through the Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) ²⁴¹, the 'Strategic Plan 2024 -2029' by the Somali Disaster Management Agency ²⁴², nor Somali National Institute of Health (NIH). ²⁴³ At the time of research, the website of Somalia's Ministry of Health and Human Services was inaccessible. ²⁴⁴

3.2.1a Completion of biological-focused IHR exercise with the WHO in past year

Score: 100

There is public evidence that Somalia has completed a national-level biological threat-focused exercise in the past year, however there is no evidence of Somalia activating their national emergency response plan for an infectious disease outbreak.

Somalia does not have a publicly available national emergency response plan for infectious disease outbreaks. ^{245 246}

Amidst cholera outbreaks in Somalia, a National Cholera Task Force was activated by International Medical Corps during the January 2024 surge in acute watery diarrhea/cholera cases. The Task Force, in collaboration with Somalia Ministry of Health and World Health Organization, developed a six-month plan to scale up cholera response activities. This included establishing a temporary cholera treatment center (CTC) in Mahaday, Somalia with a capacity of 50 beds. ²⁴⁷ However, this response was not guided by Somalia's national plan/policy.

Somalia has participated in a 2-day global pandemic simulation exercise organised by the World Health Organisation in April 2025 under the Global Health Emergency Corps (GHEC) framework. The exercise simulated an outbreak of a fictional virus and tested the countries' ability to lead their own response efforts while engaging with WHO for coordination, technical guidance and emergency support. ²⁴⁸

3.2.1b Evidence of bio-focused exercise to identify gaps/best practices

Score: 0

There is no publicly available evidence that Somalia, in the past year has identified a list of gaps and best practices in response (either through an infectious disease response, after action review or a biological-threat focused exercise) and developed a plan to improve response capabilities.

In April 2025, Somalia has participated in a 2-day global pandemic simulation exercise organised by the World Health Organisation, under the Global Health Emergency Corps (GHEC) framework. The exercise simulated an outbreak of a fictional virus and tested the countries' ability to lead their own response efforts while engaging with WHO for coordination, technical guidance and emergency support. ²⁴⁹ However, there no evidence of gaps or best practices to improve response capabilities being identified. ²⁵⁰

No further evidence of a plan to improve response capabilities in response to an infectious disease response, or after action review or a biological-threat focused exercise was found through the website of Somali National Institute of Health (NIH) ²⁵¹, and the website of Somalia's Ministry of Health and Human Services was inaccessible. ²⁵²

3.2.2a Evidence of national-level biological threat-focused exercise that includes private sector

Score: 0

There is insufficient evidence that Somalia has undergone a national-level biological threat-focused exercise in the past year that has included private sector representatives.

Somalia has participated in a 2-day global pandemic simulation exercise organised by the World Health Organisation in April 2025 under the Global Health Emergency Corps (GHEC) framework. The exercise simulated an outbreak of a fictional virus and tested the countries' ability to lead their own response efforts while engaging with WHO for coordination, technical guidance and emergency support. However, there is no evidence that private sector representatives were included.²⁵³

No further evidence of national-level biological threat-focused exercises was found through Somalia's World Health Organisation webpage ²⁵⁴, nor through the Somali National Institute of Health (NIH). ²⁵⁵

3.3.1a Existence of Emergency Operations Center (EOC)

Score: 100

There is public evidence that Somalia has an Emergency Operations Center (EOC) in place.

Somalia has a Public Health Emergency Operation Centre (PHEOC) operating under the Somali National Institute of Health (NIH), a a semi-autonomous national public health institution under the Ministry of Health and Human Services (MOH&HS). The PHEOC's objective is to create a coordinated response towards public health events/emergencies with all relevant stakeholders including states and national government entities and non-government agencies. The PHEOC also focuses on collection, collation, analysis, presentation, and utilization of health event data and information to guide the response; as well as designing appropriate health messages for the creation of public awareness, community engagement, and social mobilization. ²⁵⁶

3.3.1b Requirement for EOC to conduct/evidence EOC conducts at least annual drills

Score: 0

There is insufficient public evidence that Somalia's Emergency Operations Center (EOC) is required to conduct a drill for a public health emergency scenario at least once per year or is there evidence that they conduct a drill at least once per year

The Strategic Plan 2024 -2029, developed by the Somali Disaster Management Agency (SoDMA) in 2023, under its Section 9, calls for "organization of joint disaster response drills and simulations with the Federal Member States (FMS) (pg. 26). In Table 2 titled 'Implementation, Monitoring and Evaluation Matrix', the Plan specifically lists activites to "Design and conduct realistic disaster scenarios for mock drills in different regions", "Evaluate team performance post-drill and
provide feedback", and "Use drill outcomes to refine disaster". These activities are to be conducted "1 per annum from Q4 2027", with SoDMA, local communities, and strategy teams being the key stakeholders (pg. 52). ²⁵⁷ Although the Plan includes health emergencies into its Disaster Management Strategies (pg. 32), there is no evidence of requirement for drills to be conducted specifically for public health emergency scenarios. The Plan makes no mention of the Public Health Emergency Operation Centre (PHEOC).

No evidence of a mandate/evidence of public health emergency scenario drills was found on the webpage for the Public Health Emergency Operation Centre (PHEOC). ²⁵⁸

3.3.1c EOC activation within 120 minutes of identification of emergency/scenario

Score: 0

There is no public evidence to show that Somalia's Emergency Operations Center (EOC) has conducted within the last year a coordinated emergency response or emergency response exercise activated within 120 minutes of the identification of the public health emergency/scenario.

No evidence was found through the Somali National Institute of Health (NIH) website ²⁵⁹, nor the World Health Organisation's country page for Somalia. ²⁶⁰ At the time of research, the website of Somalia's Ministry of Health and Human Services was inaccessible. ²⁶¹

3.4.1a Joint exercise/procedures for potential deliberate biological events

Score: 0

There is insufficient publicly available evidence that Somalia public health and national security authorities have carried out an exercise to respond to a potential deliberate biological event (i.e. bioterrorism attack) or standard operating procedures, guidelines, MOUs or other agreements between the public health and security authorities to respond to a potential deliberate biological event (i.e. bioterrorism attack).

According to the World Health Organisation (WHO) Joint External Evaluation of IHR Core Capacities (JEE) of the Republic of Somalia, 17 to 21 October 2016, there is no legislation or written agreements between the two sectors, but there is some ad hoc collaboration. There is evidence of collaboration between security authorities and the Ministry of Health (MoH) in Ebola preparedness, but not any collaboration over responding to a potential deliberate biological event. ²⁶²

No furhter evidence in the form of standard operating procedures, guidelines, memorandums of understanding (MOUs), or other agreements was found through the websites of Ministry of Defence ²⁶³, National Institute of Health (NIH) ²⁶⁴, and the website of Somalia's Ministry of Health and Human Services was inaccessible at the time of research. ²⁶⁵

3.5.1a Risk communication plan for specific use during a public health emergency

Score: 0

There is insufficient evidence that Somalia has a risk communication plan that is specifically intended for use during a public health emergency.

According to the World Health Organisation (WHO) Joint External Evaluation of IHR Core Capacities (JEE) of the Republic of Somalia, conducted 17 to 21 October 2016, "None of the [Ministries of Health] (MOHs) has an ERC strategy and there are no standard operating procedures (SOPs) on how to coordinate ERC during an emergency." However, the JEE notes that despite ERC being a new concept for the three Somali administrative zones, there "is a solid basis on which ERC capacity could be built."²⁶⁶ This includes, training public communications teams of Somaliland and Puntland in ERC activities, using mass media mechanisms for emergency communications, and implementation of the communication piece of the Comprehensive Multi-Year Strategy for Immunization 2016-2020. ²⁶⁷

The Strategic Plan 2024 -2029, developed by the Somali Disaster Management Agency in 2023 under its Section 4.7 'Communication and Public Awareness' contains strategies such as: establishing dedicated communication channels, establishing a dedicated media and communication unit to manage public relations, awareness campaigns, and disaster alerts; developing a comprehensive communication strategy detailing channels, frequency, and content; training command centre staff on effective communication techniques to ensure clear and concise dissemination of information (pg. 73-75). ²⁶⁸ These strategies are aimed at all natural and man-made disasters, however they are not specifically intended for use during a public health emergency. ²⁶⁹

The Public Health Emergency Operations Center, operating under the Somali National Institute of Health (NIH), on its webpage states that its objectives include "designing appropriate health messages for the creation of public awareness, community engagement, and social mobilization." ²⁷⁰ No further evidence of a risk communication plan that is specifically intended for use during a public health emergency was found through the website of National Institute of Health (NIH) ²⁷¹, and the website of Somalia's Ministry of Health and Human Services was inaccessible at the time of research. ²⁷²

3.5.1b Inclusion of different population & sector needs in risk communication plan

Score: 100

There is evidence that Somalia has a risk communication plan on how messages will reach populations and sectors with different communications needs.

The Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) developed by the Ministry of Health and Human Services under its Annex A, 'Policy Matrix', it calls for effective communication supported by sound evidence-based planning is needed to nurture public awareness of quality improvements, as well as of harmful practices. Messages must be technically sound and attractively packaged to gain attention in the competitive information environment. Under Annex A, it also states that "two-way communication is essential to manage effective response networks and channels must be kept open between crises to be promptly activated. For instance, the community health workers who contributed to the response to COVID-19 should remain ready for the next threat". ²⁷³ However no explicit risk communication plan for different communications needs was found.

The Strategic Plan 2024 -2029, developed by the Somali Disaster Management Agency in 2023 under its Section 4.7 'Communication and Public Awareness' contains strategies such as "developing localized training modules that consider the unique challenges and context of disaster management in Somalia; and engaging local experts and community leaders in the training process to ensure relevance and applicability." The Plan also calls for collaborating with media and communication agencies through press conferences and media briefings to disseminate the action plan and other important updates, for wider outreach. Additionally, the Plan recommends utilizing Civil Society Organizations (CSOs) grassroots reach to engage with communities more effectively, by collaborating with CSOs on campaigns to raise awareness about disaster risks and preparedness (pg. 73-74). ²⁷⁴

3.5.1c Designation of a specific government spokesperson during a public health emergency

Score: 0

There is no public evidence that Somalia has a risk communication plan (or other legislation, regulation or strategy document used to guide national public health response) designate a specific position within the government to serve as the primary spokesperson to the public during a public health emergency.

No evidence of a designated spokesperson to the public during a public health emergency was found through the Strategic Plan 2024 -2029 ²⁷⁵, Somali Disaster Management Agency's website ²⁷⁶, and the website of Somalia's Ministry of Health and Human Services was inaccessible at the time of research. ²⁷⁷

3.5.2a Government use of media platforms to share info on public health emergencies

Score: 100

There is publicly available evidence that in the past year, Somalia's public health system has regularly shared messages via online media platforms to inform the public about ongoing public health concerns.

During an Mpox outbreak in August 2024, the Ministry of Health and Human Services shared a public health awareness post on X (formerly Twitter) containing signs & symptoms, as well as prevention measures for Monkeypox in both Somali and English language. ²⁷⁸

The Ministry of Health and Human Services is also active via its Facebook page, where it regularly shares updates on the Ministry's activities, participation in events/conferences/meetings, etc. The most recent post is from 11th October 2025, commemorating International Day of Mental Health. ²⁷⁹

The website of Somalia's Ministry of Health and Human Services was inaccessible at the time of research. ²⁸⁰

3.5.2b Evidence that senior leaders have shared mis/disinformation on infectious diseases

Score: 100

There is no publicly available evidence that Somalia's senior leaders (president or ministers) have shared misinformation or disinformation on infectious diseases in the past two years.

In April 2021, a news media outlet 'Horn Observer' reported that that the Somali Federal President, Mohamed Abdullahi Farmajo lied about getting Covid-19 vaccination jab on 16 March 2021, as he thought that "he could not trust the local health workers and existing cold chain supply systems to keep the vaccines safe are not adequate in Somalia." ²⁸¹ However the reporting is from more than two years ago. No recent evidence of misinformation/disinformation on infectious diseases being shared by Somalia's senior leaders was found through the local and international news media websites. ^{282 283 284}

On the contrary, in a video posted by the Ministry of Information of Somalia in July 2025 on its Facebook page, the Minister of Information of the Federal Government, in the context of Mpox outbreak, said that the government has deemed the spread of false news to be unacceptable, and has submitted a draft resolution to the Council of Ministers. ²⁸⁵

3.6.1a Percentage of households with Internet

Score: 11.9

3.6.2a Mobile-cellular telephone subscriptions per 100 inhabitants

Score: 29.18

3.6.3a Gender gap in access to a mobile phone (percentage points)

Score: 90

3.6.4a Gender gap in access to the Internet (percentage points)

Score: 75

3.7.1a Restrictions on export/import of medical goods due to an infectious disease outbreak

Score: 100

There is insufficient public evidence that Somalia has implemented restrictions on export/import of medical goods due to an infectious disease outbreak.

In May 2024, the Ministry of Finance issued a revised 'General Customs Regulation (originally published in 2020), which, under its 'Part 4 Prohibited Imports and Exports' lays out regulations to establish clear guidelines on prohibited imports and exports to safeguard public health, safety, and security (pg. 7-10). However, no evidence of import/export prohibitions specific to infectious disease outbreak was found. ²⁸⁶

A December 2024 announcement made by the Ministry of Health & Human Services stated that the Ministry is "enforcing comprehensive regulatory measures for Health products and Technologies, including medicines, biologics, medical devices, herbal medicines, food supplements, medicated cosmetics, and tobacco." However, the regulations were not introduced in response to an infectious disease outbreak. ²⁸⁷

No further evidence of import/export restrictions on medical goods was found through the websites of Somalia Interim National Medicines Regulatory Authority (NMRA) ²⁸⁸ and Ministry of Commerce and Industry. ²⁸⁹

3.7.1b Restrictions on movement and/or exports/imports due to disease outbreak

Score: 100

There is insufficient public evidence that Somalia has implemented restrictions on export/import of non-medical goods due to an infectious disease outbreak.

In May 2024, the Ministry of Finance issued a revised 'General Customs Regulation (originally published in 2020), which, under its 'Part 4 Prohibited Imports and Exports' lays out regulations to establish clear guidelines on prohibited imports and exports to safeguard public health, safety, and security (pg. 7-10). However, no evidence of import/export prohibitions specific to infectious disease outbreak was found. ²⁹⁰

A December 2024 announcement made by the Ministry of Health & Human Services stated that the Ministry is "enforcing comprehensive regulatory measures for Health products and Technologies, including medicines, biologics, medical devices, herbal medicines, food supplements, medicated cosmetics, and tobacco." However, the regulations were not introduced in response to an infectious disease outbreak. ²⁹¹

No further evidence of import/export restrictions on medical goods was found through the websites of Somalia Interim National Medicines Regulatory Authority (NMRA) ²⁹² and Ministry of Commerce and Industry. ²⁹³

3.7.2a Evidence of travel ban due to an infectious disease outbreak

Score: 100

There is no publicly available evidence that in the past year, Somalia has implemented inbound/outbound travel restrictions due to an infectious disease outbreak.

In February 2025, the Ministry of Health and Human Services published a press notice requiring all travellers arriving to or departing from Somalia to present a valid Yellow Fever vaccination certificate, with guidance to vaccinate ≥10 days before travel. ²⁹⁴
The World Health Organisation's webpage from May 2023 containing guidance on Yellow Fever states that "In accordance with the International Health Regulations (IHR), countries have the right to require travellers to provide a certificate of yellow fever vaccination.". ²⁹⁵ Somalia’s measure is therefore consistent with IHR.

No further evidence of inbound/outbound travel restrictions due to an infectious disease outbreak in the last year were found. ^{296 297}

3.7.2b Risk-based approach to international travel-related measures

Score: 100

There is public evidence that Somalia uses a risk-based approach to international travel-related measures.

Somalia is an International Health Regulations (IHR )2005 State Party. ²⁹⁸ Therefore the Ministry of Health and Human Services, on behalf of the Federal Republic of Somalia has agreed to be in compliance with the travel-related measures outlined in the IHR 2005 under its Article 30 'Travellers under public health observation'. Specifically under IHR Article 23, the State Party concerned may, "subject to Articles 32, 42 and 45, deny entry to that traveller. If there is evidence of an imminentpublic health risk, the State Party may, in accordance with its national law and to the extent necessaryto control such a risk, compel the traveller to undergo or advise the traveller". ²⁹⁹

A 2020 Points of Entry Baseline Assessment published by the International Organization for Migration (IOM) states that as of June 2020, 69% (33 of the 48) of the Point of Entry (PoEs) assessed did not have an ongoing screening process. ³⁰⁰

No further evidence of a risk-based approach to international travel was found through the website of Immigration and Citizenship Agency of Somalia. ³⁰¹

4.1.1a Doctors per 100,000 people

Score: 0.15

4.1.1b Nurses and midwives per 100,000 people

Score: 0

4.1.1c Updated health workforce strategy to address human resource shortfalls

Score: 100

There is evidence that Somalia has a health workforce strategy in place (which has been updated in the past five years) to identify fields where there is an insufficient workforce and strategies to address these shortcomings.

The Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) released by the Ministry of Health and Human Services in December 2022, under its list of current challenges acknowledges "inadequate health workforce deployed in remote and hard-to-reach areas"(pg. 18).

Subsequently, the HSSP III under its policy priorities lists " to develop a health workforce that addresses the priority health needs of the Somali population, which is adequate in number, well trained, equitably distributed and motivated to provide essential health services" (pg. 32). One of the main pillars of HSSP III is restructure the health workforce. This is to be done by enhancing the production, utilization, and maintenance of health workers via first strengthening of training programmes, and secondly; through effective in-service training. Attempts also need to be made to rationalize the pay structures to allow for improved retention and equitable distribution (pg. 33). The focus is on improving skills, rather than expanding only the total number of health workers in Somalia. ³⁰²

The Policy matrix table further contains the Feasibility and risks analysis, a list of capacity and resource requirements, along with linkages to other stakeholders (pg. 38). ³⁰³

4.1.1d Health system capacity for essential health services

Score: 0

There is insufficient publicly available evidence that Somalia has sufficient capacity within its health system to deliver essential health services.

According to the Joint external evaluation of IHR core capacities, the country receives a score of 1. The JEE says that there seems to be formal procedures and plans in Somaliland and Puntland, but not in Mogadishu and the South Central zone. The National Health Professional Council draft law for South Central zone has sections for temporary and limited registration that require the applicant to be resident in the country in order to be eligible to apply for registration. The law should be updated to ensure fast-track registration for foreign medical and health professionals during emergencies. Although there are regulatory bodies in Puntland and Somaliland the system is still in the development stage and needs time to address all issues for sending and receiving health personnel, such as liability, safety, and payments. Given that the three Somali zones are heavily affected by emergencies and suffer from staff shortages, priority should be given to joining some of the regional/international emergency response networks, such as the Global Outbreak Alert and Response Network. ³⁰⁴

According to the 2024 States Parties Self-Assessment Annual Report (SPAR) submitted by Somalia, under its Section C9 'Health service provision', Somalia has received a score of 40 for access to essential health services; and an average Capacities Score of 33%. ³⁰⁵ This indicates relatively low capacity in delivering essential health services as evaluated under IHR relevant hazards.

The latest 2021 Universal health coverage (UHC) service coverage index, also known as 'SDG Goal 3.8.1 – Coverage of essential health services' by World Health Organisation, gave Somalia a score of 27 (out of 100) ³⁰⁶ This indicates large gaps in access and capacity to cater to reproductive, maternal, newborn and child health, infectious diseases, non-communicable diseases and service capacity and access, among the general and the most disadvantaged population. ³⁰⁷

4.1.1e Essential health services continuity plan for public health emergencies

Score: 0

There is insufficient public evidence that Somalia has a plan to ensure continuity of essential health services during a public health emergency.

The Essential Package of Health Services Implementation Strategic Plan (EPHS-ISP) released by the Ministry of Health and Human Services in June 2021 under its Annex 1 (pg 20-48) contains a list of the EPHS interventions, along with specific implementation strategies for infectious and non-infectious diseases, categorised by various levels : Community, Primary health unit, Health Centre, District Hospital, and Regional/ National Hospital. This includes Emergency care through Community based first aid interventions in children and adults; services and access to medicine for reproductive, maternal and new-born health, such as coordinated prenatal visits for pregnancy with complications, including provision relevant preventive therapies. ³⁰⁸ It also calls for development of standard core list of minimum needs of medicines, supplies and equipment of the EPHS for different level of services shall be developed taking into account the epidemiological requirements of the different regions (pg. 13). ³⁰⁹

The Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) released by the Ministry of Health and Human Services in December 2021, acknowledges the need to strengthen essential public health functions (pg. 10) and states that the HSSP III's design and the development has been informed by the Essential Package of Health Services (EPHS) 2020 (pg. 10). The goal of HSSP III is to "provide equitable, efficient and affordable quality essential priority health services as close to the communities and families as possible based on the EPHS and Primary Health Care (PHC) approach". (pg. 14). ³¹⁰ However the Plan itself does not contain strategies for continuity of essential health services during a public health emergency.

4.1.2a Hospital beds per 100,000 people

Score: 19.15

4.1.2b In-country capacity to isolate patients with highly communicable diseases

Score: 0

There is no publicly available evidence that Somalia has the capacity to isolate patients with highly communicable diseases in a biocontainment patient care unit and/or patient isolation room/unit located within the country.

The World Health Organisation (WHO) Joint External Evaluation of IHR Core Capacities (JEE) of the Republic of Somalia, conducted 17 to 21 October 2016, discusses isolation in the context of points of entry (PoEs) noting that "no public health contingency plan to respond to public health emergencies of any hazards exists at any PoE, nor any designated spaces to isolate ill passengers or animal quarantine." The JEE also notes that there are legal provisions regarding quarantine of animals, but not in the context of zoonotic diseases. ³¹¹

No further evidence confirming the current existence of specialized biocontainment patient care units or isolation rooms/units designed for patients with highly communicable diseases was found through the Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) ³¹², Somali Disaster Management Agency's Strategic Plan 2024 -2029 ³¹³, website of Somali Disaster Management Agency ³¹⁴; and the website of Somalia's Ministry of Health and Human Services was inaccessible at the time of research. ³¹⁵

4.1.2c Demonstrated capacity / evidence of plan to expand isolation capacity

Score: 0

There is no publicly available evidence that Somalia has developed, updated or tested a plan to expand isolation capacity in response to an infectious disease outbreak in the past two years.

A Health Emergency Programme Update by the World Health Organisation (WHO) from May 2020 stated that Galmudug state ministry of health has opened functional isolation center in Dusamareeb, Somalia. This isolation had the capacity of 28 Beds supported by WHO, and a total of 42 (19 are female, 23 are male) health workers were recruited and trained to support the isolation. ³¹⁶

No further evidence of expansion in isolation capacity in response to an infectious disease outbreak in the past two years was found through Somalia's WHO country page ³¹⁷, website of Somali Disaster Management Agency ³¹⁸; and the website of Somalia's Ministry of Health and Human Services was inaccessible at the time of research. ³¹⁹

4.2.1a National procurement protocol for the acquisition of routine laboratory/medical supplies

Score: 0

There is insufficient publicly available evidence that Somalia has a national/international international procurement protocol or contract framework in place which can be utilized by the Ministries of Health and Agriculture for the acquisition of laboratory supplies and medical supplies for routine needs.

The Ministry of Health and Human Services has issued document titled 'Placement of Framework Contracts and Short-Listing (Prequalification) of Providers for Works, Services, or Supplies for Financial Years 2022-24'. It defines procedures for short-listing providers (suppliers) for supplies, works, and services , allows them to run short-listing and framework contracts for supplies, with Part 2 & 3 detailing the application procedure for potential suppliers. Annex B contains a list of items/supplies eligible for procurement through this procedure which include items such as: Drugs, laboratory equipment, reagents, chemicals, and medical sundries, Medical Uniforms, curtains, protective wear and carpets (pg. 23). ³²⁰

However, the above document is no longer valid for the financial year 2025, and no evidence of a new/updated procurement protocol/framework was found through the websites of Ministry of Commerce and Industry ³²¹, Ministry of Agriculture and Irrigation ³²²; and the website of Somalia's Ministry of Health and Human Services was inaccessible at the time of research. ³²³

4.2.2a Stockpile of medical supplies for national use during a public health emergency

Score: 0

There is insufficient evidence that Somalia has a stockpile of medical supplies for national public health emergencies, and there is no evidence of a plan to ensure equitable distribution.

The Ministry of Health and Human Services had released a National Medicines Supply Chain Master Plan in March 2015, which aims to ensure that vital and essential medicines of approved quality will be readily available to public sector health facilities, for use in the prevention, diagnosis, and treatment of priority health problems, in adequate quantities and at the lowest possible cost (pg. 5). The Plan lays out strategies for procurement, inventory management using an automated inventory control tools. The National Medicine Supply Agency's (NMSA) stockpile is expected to implement vital & essential medicines list (EML) in line with Essential Package of Health Services’ (EPHS) requirements (pg. 13), whilst working for procurement services on low-demand/special medicines which are not in the ELM for procurement by the ‘new NMSA’. ³²⁴ However, the Plan does not explicitly contain a stockpile for national public health emergencies; and no evidence of a plan to ensure equitable distribution in an emergency was found.

According to a May 2025 update from DHIS2 website, ICRC developed the Pharmacy Stock Management (PSM) system, a DHIS2-based application designed to digitize and standardize stock tracking across supported facilities. This indicatess that Somalia does have an operational stockpile of medical supplies. ³²⁵

No further information about the country's medical stockpiles was found through the Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) ³²⁶, Somali Disaster Management Agency's Strategic Plan ³²⁷; and the website of Somalia's Ministry of Health and Human Services was inaccessible at the time of research. ³²⁸

4.2.2b Stockpile of laboratory supplies for national use during a public health emergency

Score: 0

There is insufficient publicly available evidence that Somalia has a stockpile of laboratory supplies (e.g. reagents, media) for national use during a public health emergency.

According to a news update by Africa Centers for Disease Control and Prevention (CDC) from September 2024, Somalia’s Federal Ministry of Health and Human Services, with support from Africa CDC is developing a 'laboratory strategy plan'. This Plan is expected to align with global standards such as the International Health Regulations (IHR 2005) as well as "address gaps in lab infrastructure, sets priorities, and outlines strategies to improve diagnostics, train personnel, and ensure essential supplies". ³²⁹

The website of National Institute of Health (NIH) Somalia also confirms that the NIH is "working to strengthen the laboratory systems in the country by developing and implementing a national laboratory strategic plan." However the Plan is not released/publicly available at the time of research. ³³⁰

No further evidence of a stockpile of laboratory supplies (e.g. reagents, media) for national use during a public health emergency was found through the Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) ³³¹, Somali Disaster Management Agency's Strategic Plan ³³²; and the website of Somalia's Ministry of Health and Human Services was inaccessible at the time of research. ³³³

4.2.2c Annual review of national stockpile to ensure sufficient supply

Score: 0

There is insufficient public evidence that Somalia conducts or requires an annual review of the national stockpile to ensure the supply is sufficient for a public health emergency.

The Ministry of Health and Human Services had released a National Medicines Supply Chain Master Plan in March 2015, which aims to ensure that vital and essential medicines of approved quality will be readily available to public sector health facilities, for use in the prevention, diagnosis, and treatment of priority health problems, in adequate quantities and at the lowest possible cost (pg. 5). Under its 'strategies to address the core components of the NMSCMP', the Plan calls for "getting feedback from users, review evidence and periodically update Standard Treatment Guidelines (STGs) and essential medicines list (EML)" (pg. 9). it also calls for "designing and performing regular quality assurance and performance monitoring during the full supply chain of essential medicines" (pg. 10). ³³⁴ However the Plan does not explicitly cover public health emergencies (PHEs), nor are these stockpiles specifically intended to be used during PHEs.

While the Health Sector Strategic Plan 2022–2026 (HSSP III) outlines a framework for health system development and includes provisions for biennial reviews, these reviews focus on broader health system objectives and do not specifically address the adequacy or review of national stockpiles for emergencies. ³³⁵

4.2.3a Plan/agreement to produce/procure medical supplies during a public health emergency

Score: 100

There is public evidence that Somalia has a plan to leverage public sector's domestic manufacturing capacity to produce medical supplies and a plan to procure medical supplies for national use during a public health emergency; however there is no evidence of a mechanism to expedite medical supplies through PoEs.

A key initiative in the National Transformation Plan (NTP 2025-2029), developed by the Ministry of Planning, Investment and Economic Development, is focused on reducing reliance on imports by expanding local pharmaceutical production, enhancing the supply chain, and producing a range of essential medicines to strengthen healthcare systems (pg. 26). ³³⁶ The NTP under its Section 15.4 lists one of its key interventions to "strengthen Somalia’s pharmaceutical landscape, safeguarding public health nationwide through incentives for local production and targeted funding mobilisation." The implementation for this is expected to begin in January 2025 and end in December 2027. By 2028, this initiative targets 100% registration and approval of products and dossiers, along with 100% port coverage (pg. 351). ³³⁷

The Ministry of Health and Human Services had released a National Medicines Supply Chain Master Plan in March 2015. Under its 'strategies to address the core components of the NMSCMP', the Plan calls for "getting feedback from users, review evidence and periodically update Standard Treatment Guidelines (STGs) and essential medicines list (EML)" (pg. 9). it also calls for "designing and performing regular quality assurance and performance monitoring during the full supply chain of essential medicines" (pg. 10). ³³⁸ However the Plan does not explicitly cover public health emergencies (PHEs), nor are these stockpiles specifically intended to be used during PHEs.

The Somalia Crisis Response Plan 2021 developed by International Organization for Migration (IOM) states that IOM shall provide Health services in Somalia during a public crisis, in line with the national Essential Package of Health Services (EPHS) framework. This includes prepositioning of essential medicines, medical supplies, medical equipment, personal protective equipment and infection prevention and control supplies to ensure uninterrupted supply in the event of an emergency; supporting mass vaccination at the entrance points to IDP sites, thus increasing immunization coverage and reducing outbreaks of communicable diseases; and facilitating the deployment of rapid response teams at key points of entry to enhance surveillance at points of entry through screening and referrals in the event of a public health emergency (pg. 4). ³³⁹

No evidence for a plan/mechanism to expedite medical supplies through points of entry was found via the National Medicines Supply Chain Master Plan ³⁴⁰, Ministry of Ports and Marine Transport ³⁴¹, nor Customs Service Charter of Somalia Revenue Directorate. ³⁴²

4.2.3b Plan/agreement to produce/procure lab supplies during a public health emergency

Score: 0

There is insufficient public evidence that Somalia has a plan/agreement to leverage public and/or private sector domestic (including regional) manufacturing capacity to produce, procure, or expedite medical supplies through points of entry, during a public health emergency.

According to an April 2023 update on the World Health Organisation (WHO) website, WHO has helped the Federal and State Ministries of Health establish an operational medical supply chain. Medical supplies procured and delivered by WHO include: kits for emergency health, trauma care, malaria, tuberculosis, HIV-AIDs, cholera and measles besides having medicines for treatment of all these diseases, as well as personal protective equipment (PPEs), long lasting insecticidal nets to control malaria, oxygen concentrators, solar panels, electricity generators, and ambulances among others public health, IT and office materials. ³⁴³ However, this is in response to a recent public health emergency, and not an established mechanism.

The Somalia Crisis Response Plan 2021 developed by International Organization for Migration (IOM) states that IOM shall provide Health services in Somalia during a public crisis, in line with the national Essential Package of Health Services (EPHS) framework. This includes prepositioning of essential medicines, medical supplies, medical equipment, personal protective equipment and infection prevention and control supplies to ensure uninterrupted supply in the event of an emergency; supporting mass vaccination at the entrance points to IDP sites, thus increasing immunization coverage and reducing outbreaks of communicable diseases; and facilitating the deployment of rapid response teams at key points of entry to enhance surveillance at points of entry through screening and referrals in the event of a public health emergency (pg. 4). However the Plan does not explicitly cover laboratory supplies. ³⁴⁴

A key initiative in the National Transformation Plan (NTP 2025-2029), developed by the Ministry of Planning, Investment and Economic Development, is focused on reducing reliance on imports by expanding local pharmaceutical production, enhancing the supply chain, and producing a range of essential medicines to strengthen healthcare systems (pg. 26). ³⁴⁵ The NTP under its Section 15.4 lists one of its key interventions to "strengthen Somalia’s pharmaceutical landscape, safeguarding public health nationwide through incentives for local production and targeted funding mobilisation." The implementation for this is expected to begin in January 2025 and end in December 2027. By 2028, this initiative targets 100% registration and approval of products and dossiers, along with 100% port coverage (pg. 351). ³⁴⁶

No evidence for a plan/mechanism to expedite laboratory supplies through points of entry was found via the National Medicines Supply Chain Master Plan ³⁴⁷, Ministry of Ports and Marine Transport ³⁴⁸, nor Customs Service Charter of Somalia Revenue Directorate. ³⁴⁹

4.2.3c Mechanism emergency logistics and supply chain management

Score: 100

There is evidence that Somalia has a system or mechanism in place for emergency logistics and supply chain management and it covers the public and private sector. However, there is insufficient evidence of the system/mechanism being exercised, reviewed, evaluated and updated on a regular basis; nor does it cover specific considerations such as cold chain management for vaccines.

The Somalia Disaster Management Agency (SoDMA) in its 'Strategic Plan 2024 -2029' released in December 2023 states that the National Emergency Operations Centre is responsible for procurement and logistics, including managing logistics and supply chain operations. (pg. 64) ³⁵⁰ Under Table 1: 'Stakeholder Analysis of SoDMA , the Strategic Plan calls for SoDMA to utilize the private sector's logistical capabilities for disaster response. As an engagement strategy, it recommends Public-Private Partnerships via collaborative projects such as Corporate Social Responsibility (CSR)Initiatives, that leverage private sector resources and expertise, and aligning CSR projects with SoDMA's disaster management needs (pg. 27). ³⁵¹ The Strategic Plan does not contain further evidence of a detailed emergency logistics mechanism, nor a system for its regular review/evaluation.

The Ministry of Health and Human Services had released a National Medicines Supply Chain Master Plan in March 2015. The Plan establishes a centralized National Medicine Supply Agency ("New NMSA"). This agency's core functions include procurement, warehouse and distribution (storage and transport), and managing the Logistics Management Information System. Under the Plan's 'strategies to address the core components of the NMSCMP', the Plan calls for "getting feedback from users, review evidence and periodically update Standard Treatment Guidelines (STGs) and essential medicines list (EML)" (pg. 9). it also calls for "designing and performing regular quality assurance and performance monitoring during the full supply chain of essential medicines" (pg. 10). ³⁵² However the Plan is intended for general use, and does not contain a mechanism specific for public health emergencies. No evidence of cold chain management for vaccines was found. ³⁵³

According to an April 2023 update on the World Health Organisation (WHO) website, WHO has helped the Federal and State Ministries of Health establish an operational medical supply chain. Medical supplies procured and delivered by WHO include: kits for emergency health, trauma care, malaria, tuberculosis, HIV-AIDs, cholera and measles besides having medicines for treatment of all these diseases, as well as personal protective equipment (PPEs), long lasting insecticidal nets to control malaria, oxygen concentrators, solar panels, electricity generators, and ambulances among others public health, IT and office materials. ³⁵⁴ However, this is in response to a recent public health emergency, and not an established mechanism.

In February 2025, the World Bank issued Somalia a grant to extend its COVID 19 support by "strengthening the transportation, supply chain and logistics capacity for in-country distribution of Project COVID-19 Vaccines, including implementing a climate sensitive vaccination planning, the procurement or repair/refurbishment of climate friendly cold-chain equipment". Under Section 3.3. the project also includes renovating and expanding the central cold chain storage facility (pg. 4). ³⁵⁵ Although the cold chain equipment & logistics support is generalised, the vaccination support is specific for one disease only.

4.3.1a Plan/program/guidelines for dispensing MCMs during a public health emergency

Score: 0

There is insufficient public evidence that Somalia has a plan/program/guidelines in place for dispensing medical countermeasures (MCM) for national use during a public health emergency.

In a 2024 WHO’s Health Emergency Appeal 2024, thr WHO has commited to support the Somali government to "sustain the capacities of essential public health functions which were built during the COVID-19 pandemic response, covering collaborative surveillance, coordination, community protection, access to safer care and access to medical countermeasures in the event of any major health emergencies in the country."³⁵⁶

No further evidence of published, operational plan or guideline that specifies how medical countermeasures (antibiotics, vaccines, therapeutics, diagnostics) should be dispensed nationally during a declared public health emergency was found through the Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) ³⁵⁷, Somali Disaster Management Agency's Strategic Plan 2024 -2029 ³⁵⁸, nor Somali National Medicines Policy. ³⁵⁹

4.3.2a Plan to receive foreign health personnel during a public health emergency

Score: 0

There is insufficient evidence that Somalia has public plan in place to facilitate workforce surge in an emergency.

The Somalia Health Sector Strategic Plan (HSSP III) 2022‑2026, developed by the Ministry of Health and Human Services, includes a pillar 'Restructure the health workforce' which focuses on enhancing the production, utilisation, and maintenance of health workers through the strengthening of training programmes, and effective in-service training. The focus is on "improving skills, rather than expanding the true number of health workers." (pg. 15). ³⁶⁰

The Public Health Emergency Operations Center operating under National Institute of Health Somalia, on its website states that its core objectives include "Mobilization and deployment of resources, including surge capacity, services, and supplies to support all PHEOC functions". ³⁶¹

Additionally, the 'Capacity-Building Development Plan' on NIH website states that its objective is to "improve capacity-building development for the health of the Somali people through innovative integration of research, education, training, and prevention and control of diseases". There is also evidence of Field epidemiology training programs (FETPs) being conducted, which targets public health professionals and surveillance/IDSR officers at national, state, regional, and district levels. It provides short training to enhance the epidemiological skills of health professionals and services. ³⁶²

4.3.2b Plan to facilitate workforce surge in an emergency

Score: 0

There is no public evidence that Somalia has a public plan in place to receive health personnel from other countries to respond to a public health emergency.

The Public Health Emergency Operations Center operating under National Institute of Health Somalia, on its website states that its core objectives include "Mobilization and deployment of resources, including surge capacity, services, and supplies to support all PHEOC functions".³⁶³ However there is no evidence of receiving personnel from other countries.

No further evidence of a plan to receive health personnel from other countries was found through the Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) ³⁶⁴, nor Somali Disaster Management Agency's Strategic Plan. ³⁶⁵

4.3.2c Plan to redeploy existing health personnel within the country

Score: 0

There is insufficient public evidence that Somalia has a plan in place to redeploy existing health personnel within the country covering either geographical or role redeployment.

The Public Health Emergency Operations Center operating under National Institute of Health (NIH) Somalia, on its website states that its core objectives include "Mobilization and deployment of resources, including surge capacity, services, and supplies to support all PHEOC functions". ³⁶⁶ However, the NIH website does not contain a plan for explicit geographical or role redeployment health personnel.

The Somalia Health Sector Strategic Plan (HSSP III) 2022-2026, developed by the Ministry of Health and Human Services, includes workforce-related priorities under its strategic pillar 'Restructure the health workforce' which focuses on enhancing the production, utilisation, and maintenance of health workers through the strengthening of training programmes, and effective in-service training (pg. 15). However, this is framed in general terms (ie. improving skills, planning) rather than specifically outlining redeployment during emergencies. ³⁶⁷

No further evidence of a plan for geographical or role redeployment of health personnel was found through the Strategic Plan 2024 -2029 by the Somali Disaster Management Agency. ³⁶⁸

4.4.1a Constitutional guarantee of citizens’ right to medical care

Score: 75

There is evidence that Somalia's constitution explicitly guarantees citizens’ right to medical care, however it is not explicitly gauranteed to be free.

The Provisional Constitution adopted on 1 August 2012 by the Federal Republic of Somalia under its Article 27 : 'Economic and Social Rights' explicitly states that, "every person has the right to healthcare, and no one may be denied emergency healthcare for any reason, including lack of economic capability". ³⁶⁹

4.4.1b Access to skilled birth attendants (% of population)

Score: 0

4.4.1c Out-of-pocket health expenditures per capita, PPP (current international $)

Score: 98.39

4.4.1d Coverage of essential health services through universal health coverage

Score: 0

4.4.1e Total population pushed below a relative poverty line by household health expenditure (60% of media daily per capita consumption or income)

Score: 95.89

4.4.1f Rate of mortality amenable to health care

Score: 99.24

4.4.2a Guaranteed paid sick leave

Score: 66.67

There is publicly available evidence that workers in Somalia are guaranteed paid sick leave for physical health problems.

Article 32 of the The Law for the Somali Civil Servants (No. 11), states that permanent government employees are entitled to sick leave. The employee is entitled to receive full salary for the first six months of sick leave, and half salary if the sick leave extends beyond six consecutive months. ³⁷⁰ No mention of sick leaves for mental health problems was found.

For the general population, the Somali Labour Code of 1972, under its Section 57(b) gaurantees the employee a sick leave for three months, with entitlement to full salary for the first 30 days, and half salary afterwards. ³⁷¹ No mention of sick leaves for mental health problems was found.

4.4.3a Government prioritisation of care for healthcare workers during response

Score: 0

There is insufficient publicly available evidence that Somalia has issued legislation, a policy, or a public statement committing to provide prioritized healthcare services to healthcare workers who become sick as a result of responding to a public health emergency.

The Law of the Rights of Patients and Health Workers (Xeerka Nidaamiyaha Xuquuqda Bukaanka Iyo Waajibaadka Shaqaalaha Caafimaadka), released by the Ministry of Health and Human Services in 2023, under its Article 19 'Rights of Health Workers' states that the health facilities must take measures to reduce injury or harm that may occur to health workers while working in the medical facilities, including transmission of diseases (pg 11). No further evidence of prioritization of healthcare services to healthcare workers was found in the document. ^{372 373}

A news article from 2023 released by the Somali National Union of Healthcare Workers (SONUH) advocates for workplace safety of healthcare worksers in healthcare settings including access to mental health support and counseling services for healthcare workers who may experience trauma or burnout as well as establishment of health and safety committees within healthcare facilities. ³⁷⁴ However, the SONUH does not hold legislative power.

No further evidence of government issued legislation, a policy, or a public statement committing to provide prioritized healthcare services to healthcare workers was found through the Facebook ³⁷⁵ and X (formerly Twitter) ³⁷⁶ social media pages of the Ministry of Health and Human Services; and the Ministry's website was inaccessible at the time of research. ³⁷⁷

4.5.1a Existence of system for communication during a public health emergency

Score: 100

There is publicly available evidence that Somalia has a system in place for public health officials and healthcare workers to communicate during a public health emergency.

The Somalia Disaster Management Agency (SoDMA) has established a National Emergency Operations Center (NEOC) which serves as a centralized hub for coordinating and managing responses to various emergencies such as natural disasters, pandemics, terrorist attacks, and other crises. ³⁷⁸

According to the Two Year Achievement Report (2022-2024) released by the Somalia Disaster Management Agency (SoDMA) in June 2025, the National Emergency Operations Centre
(NEOC) is equipped with the necessary communication systems, technology, and resources to quickly mobilize resources and personnel in times of crisis (pg. 7). The SoDMA has established an Emergency Call Center in Somalia for rapid response to emergencies, coordinating services of various response agencies, enhancing public safety, improving communication between the public and responders, and building capacity in emergency response personnel (pg. 8). ³⁷⁹

SoDMA also has a National Early Warning system which works closely with local authorities and communities to ensure that the warnings are communicated effectively and that necessary actions are taken to mitigate the impact of potential disasters (pg. 13). In addition to issuing warnings, SoDMA also coordinates response efforts in the event of a disaster, working with various stakeholders such as government agencies, non-governmental organizations, and international partners to ensure a coordinated and effective response. This includes providing support for emergency relief efforts, conducting damage assessments, and coordinating the distribution of aid to affected populations (pg. 13). ³⁸⁰

4.5.1b Inclusion of public and private sector in healthcare communication system

Score: 100

There is evidence that Somalia's system for public health officials and healthcare workers to communicate during an emergency encompass healthcare workers in both the public and private sector.

The Somalia Disaster Management Agency (SoDMA) has established a National Emergency Operations Center (NEOC) which serves as a centralized hub for coordinating and managing responses to various emergencies such as natural disasters, pandemics, terrorist attacks, and other crises. ³⁸¹
The Two Year Achievement Report (2022-2024) released by the Somalia Disaster Management Agency (SoDMA) in June 2025 states that the National Emergency Operations Center's (NEOC) key stakeholders include "government agencies, nongovernmental organizations, private sector entities, and community groups" to ensure a coordinated and effective response during a public health emergency. ³⁸²

The Strategic Plan 2024 -2029 developed by the SoDMA in 2023, under its Section 2.6 on 2.6Stakeholder Analysis states that, "through public-private partnerships, businesses can offer logistical support, technical expertise, and even funding for disaster management initiatives"(pg. 25). Under Section 4.6, it specifically calls for "engaging in collaborative efforts with the private sector for communication initiatives, and leveraging the resources and expertise of the private sector to enhance communication reach
and effectiveness" (pg. 75) ³⁸³

4.6.1a Evidence of national public health system monitoring and tracking of HCAIs

Score: 0

There is insufficient public evidence that Somalia has a national public health system for monitoring and tracking of healthcare associated infections (HCAI) that take place in healthcare facilities.

According to a research article published in the BioMedical Central journal in September 2025 on a cross-sectional study of 307 healthcare facilities (about 30% of listed facilities) across Somalia using WHO’s Infection Prevention and Control Assessment Framework (IPCAF) found that most facilities score poorly on healthcare associated infections (HCAI) surveillance (i.e. they do not have robust systems or fully functional monitoring of HCAIs. ³⁸⁴

No further evidence of a national public health system for monitoring and tracking of HCAIs was found through the National Institute of Health Somalia website ³⁸⁵, and the Ministry of Health and Human Services website was inaccessible at the time of research. ³⁸⁶

4.6.1b Infection prevention and control programme

Score: 0

There is insufficient public evidence that Somalia has a infection prevention and control programme in place nationally.

The Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) aims to establish a resilient health system capable of achieving health security and puts a priority focus on "the prevention and control of high burden diseases and related risk factors"( pg. 15). Under its 'Policy priorities', the Plan aims to "to improve access to EPHS of acceptable quality through implementation of EPHS to produce the desired health outcomes in terms of controlling prevalent communicable and noncommunicable diseases and improving the quality of life". Under its Monitoring and evaluation framework, it further lists "cases of communicable diseases timely and correctly identified and managed" as a key indicator to be monitored as it is considered one of the strategic drivers for boosting health care access and demand in the country (pg. 46). ³⁸⁷

The National Transformation Plan (NTP 2025-2029) released by the Ministry of Planning, Investment and Economic Development in March 2025, under its Section 15.3 containing 'Key Result Areas for Strengthening Maternal and Child Health
Services' focuses on the low vaccine coverage and resulting high burden of preventable diseases like measles, polio, and pneumonia, which contribute to elevated child mortality rates. It further states a strategic objective of achieving Universal Health Coverage of 40% by 2029 (pg. 342). ³⁸⁸

In October 2023, Somalia participated in a 10-day training workshop organised by World Health Organisation focusing on Infection prevention and control (IPC) with a focus on interactive discussions, group work, role-play, sharing of country experiences and lessons learned, field visits, and simulation exercises. ³⁸⁹

4.6.1c National plan to ensure a safe environment in health facilities

Score: 0

There is insufficient public evidence that Somalia has a plan to ensure a safe environment in health facilities nationally.

The National Policy on Occupational Safety and Health (Siyaasadda Qaranka ee Bad-qabka iyo Caafimaadka Goobaha Shaqada) released by the Ministry of Labour and Social Affairs in January 2024 calls for creation of an environment for occupational safety and health that helps reduce poor health, diseases, defects/injuries, and death among workers, across job sectors. ³⁹⁰

The Law on the Establishment of the National Health Professionals Council approved by the Federal Republic of Somalia on 16 November 2020, establishes a National Health Professional Council (NHPC) – an autonomous professional regulatory body.³⁹¹ A 2020 document by the Ministry of Health and Human Services containing the Purpose of National Health Professionals Council, under its Article 6 'Council Mandates and Functions' states that the Council is responsible for "licensing and accrediting public and private health facilities, health services and monitor quality assurance of health facilities, services and medical education" (pg. 6) ³⁹² No further evidence of a comprehensive plan for safety of health facilities was found as the website of Somali National Health Professionals Council was under development at the time of research ³⁹³

4.7.1a Requirement for ethical review before beginning a clinical trial

Score: 0

There is insufficient publicly available evidence that Somalia has a national requirement for ethical review (e.g., from an ethics committee or via Institutional Review Board approval) before beginning a clinical trial.

The Somali Researchers Association has a Research Ethics Committee which is responsible for issuing research ethical approval for research activities involving human participants in Somalia. However, it is a non-governmental body. ³⁹⁴

The Health Research Ethics Committee (HREC) at Somali Institute for Health Research (SIHR) provides scientific and ethical review of proposed human research projects, however it is also a non-governmental body. ³⁹⁵

The Research Department under the National Institute of Health (NIH) Somalia, an independent national public health agency under the Ministry of Health and Human Services, states that is responsible for "development and dissemination of guidelines to make health research more scientific and ethically sound". ³⁹⁶ In a Report of the First National Institute of Health Research Conference published by NIH Somalia in 2022, lists one of its aims to "develop health research ethics guidelines" (pg. 23). ³⁹⁷

The Somalia Interim National Medicines Regulatory Authority (NMRA) under the Ministry of Health & Human Services, on its website states that "we regulate the conduct of clinical trials to ensure that they are ethically approved and scientifically sound." However no further information on the mechanism of these ethical reviews was found through the NMRA website, and it is unclear whether ethical reviews are a requirement for conducting clinical trials. ³⁹⁸

No further evidence of such requirements for ethical review before beginning a clinical trial was found through National Institute of Health (NIH) Somalia's website ³⁹⁹ and the Ministry of Health and Human Services website ⁴⁰⁰ was inaccessible at the time of research.

4.7.1b Expedited approval for clinical trials of unregistered MCMs during epidemics

Score: 0

There is no publicly available evidence that Somalia has an expedited process for approving clinical trials for unregistered medical countermeasures (MCM) or mutual recognition of clinical trial results taking place elsewhere to treat ongoing pandemics or epidemics.

The Somalia Interim National Medicines Regulatory Authority (NMRA) according to its website is responsible for controlling/regulating medicines, biologics, medical devices, herbal medicines eetc, in Somalia. ⁴⁰¹ However, no evidence of an expedited process for approving clinical trials for unregistered medical countermeasures (MCM) was found on the NMRA website. ⁴⁰²

The Somali National Medicines Policy released by the Ministry of Health and Human Services in 2014 under its Section 2.3.5 contains regulations for importers including provisions for prioritization of registrations, and fast-track procedures for essential drugs (pg. 13). However, this provision refers to essential drugs (which are registered products) and licensing generally, rather than emergency MCMs or unregistered trial applications. ⁴⁰³

4.7.2a Existence of agency responsible for approving new human MCMs

Score: 100

There is evidence that Somalia has a government agency responsible for approving new medical countermeasures (MCM) for humans.

The National Medicines Regulatory Authority (NMRA) of Somalia, operating under the Federal Ministry of Health and Human Services (MoH), according to the regulatory functions listed on its website, is responsible for registering and licensing of all medicines, vaccines, biologicals, and medical devices before marketing or use in Somalia. Additionally, NMRA is responsible for evaluating the safety, efficacy, and quality of all human and veterinary medicinal products, as well as ensuring pharmacovigilance and post-market surveillance. ⁴⁰⁴

4.7.2b Expedited approval for human MCMs during public health emergencies

Score: 100

There is insufficient public evidence that Somalia has an expedited process for approving medical countermeasures (MCM) for human use, however there is evidence for recognition of approval decisions taking place elsewhere during public health emergencies.

A February 2021 Facebook post by WHO Somalia indicates that the Government of Somalia had approved the COVAX vaccine for emergency use. Frontline workers, Healthcare workers & elderly population in highly diseased burden districts were catogerized as a priority group & were to receive 1.2 million doses in the first allocation round. ⁴⁰⁵

The Somali National Medicines Policy released by the Ministry of Health and Human Services in 2014 under its Section 2.3.5 contains regulations for importers including provisions for prioritization of registrations, and fast-track procedures for essential drugs (pg. 13). However, this provision refers to essential drugs (which are registered products) and licensing generally, rather than emergency MCMs. ⁴⁰⁶

No further evidence of an expedited process for approving medical countermeasures (MCM) was found via the Somalia Interim National Medicines Regulatory Authority's website ⁴⁰⁷; and the Ministry of Health and Human Services's website was inaccessible at the time of research. ⁴⁰⁸

5.1.1a Submission of IHR reports to the WHO in past year

Score: 100

Somalia has submitted an IHR Self-Assessment Annual Report (SPAR) to the WHO for the last calendar year, with the latest submission in 2024.⁴⁰⁹

5.1.2a Existence of specific risk reduction strategies for epidemics and pandemics

Score: 0

There is insufficient publicy available evidence that epidemics and pandemics integrated into Somalia's national risk reduction strategy.

Somalia has a National Disaster Risk Management Policy (revised 2022) which under it's 'Non-specific hazards', acknowledges that Somalia is at risk of drought-related epidemic/disease outbreaks for water-borne diseases such as acute watery diarrhoea, cholera and measles (pg. 14). The Policy under its Outcome 1.3 calls for the Ministry of Humanitarian Affairs and Disaster Management to develop "detailed hazard maps for specific hazards produced for all disaster-prone districts, especially focusing on drought, floods, cyclone and epidemics based on historical data available, and in collaboration with existing regional/international forecasting centres" (pg. 27). Similary, under its Strategic Policy 8, it aims to conduct vulnerability assessments to map out the communities affected by disasters, specifically: drought, floods, cyclones and epidemics (pg. 34). ⁴¹⁰ However, the Policy does not explicitly contain a risk reduction strategy for pandemics.

The Strategic Plan 2024 -2029, developed by the Somali Disaster Management Agency (SoDMA) in 2023, under its Section 2.8 contains a list of 'Emerging Priorities', developed through stakeholder engagement activities, which calls for incorporating pandemic preparedness into the Agency's disaster management plans, in order to enable effective responses to health emergencies. ⁴¹¹ Although the Strategic Plan does not contain specific strategies for epidemics/pandemics; the Plan states that "SoDMA's 5-year strategic plan is informed by a thorough analysis of emerging issues and priorities" (pg. 32). ⁴¹²

5.2.1a Existence of public health emergency agreements with regional neighbors

Score: 50

There is evidence that Somalia has cross-border agreements, protocols, or MOUs with neighboring countries, or as part of a regional group, with regards to public health emergencies.

According to a press release by the Ministry of Foreign Affairs & International Cooperation from December 2024, the Federal Republic of Somalia and the United Republic of Tanzania have signed five landmark Memorandums of Understanding (MOUs) covering foreign affairs, health, tourism, defense, and education. Specifically, Somalia’s Minister of Health, and Tanzania’s Deputy Minister of Health, signed an agreement focused on improving healthcare systems in both countries. The MOU emphasizes "tackling communicable diseases, sharing expertise in public health, and strengthening healthcare delivery for underserved populations". ⁴¹³ The MOUs are not publicly released by the Ministry of Foreign Affairs & International Cooperation , therefore further details specific to public health emergencies could not be retrieved. ⁴¹⁴

A cross-border coordination meeting between Ethiopia, Kenya, and Somalia was held in July 2022 to discuss the strengthening of their cross-border coordination mechanism, improving prevention of cross-border spread of diseases, harmonizing disease surveillance and early warning systems, and initiating a joint response to transboundary health threats to institute health partnership and sustainable cross border disease control mechanisms in the context of International Health regulations (IHR 2005). The meeting resulted in the establishment of a task force specifically assigned to finalize the working documents on coordination structure to be used in fostering cross-border strategic health alliance. However, no MOU was signed. ⁴¹⁵

5.2.1b Existence of animal health emergency agreements with regional neighbors

Score: 100

There is evidence that Somalia has cross-border agreements, protocols, or MOUs with neighboring countries, or as part of a regional group, with regards to animal health emergencies.

In recognition of the challenges caused by transboundary animal diseases (TADs), Ethiopia and Somalia signed a cross border MOU in March 2019, facilitated by Intergovernmental Authority on Development (IGAD). The goal of this MOU is to strengthen collaboration and develop a coordinated regional approach towards addressing TADs. To operationalize the MOU, IGAD organized a two days meeting to launch the governance structure and develop a harmonized disease surveillance and vaccination calendar for 2022 between the two countries which took place in Djibouti, in the Republic of Djibouti from 9-10th December, 2021. ⁴¹⁶

In 2019, another MOU was signed between Somalia and Ethiopia, facilitated by IGAD Centre for Pastoral Areas and Livestock Development (ICPALD), to enhance cross border bilateral cooperation and joint coordination on agreed animal health issues and sanitary measures to improve community livelihoods and development in the following areas: transboundary animal diseases, mapping of stock routes and natural resources, enforcement of regulations on veterinary drug importation and use, facilitation of livestock trade, access to livestock related infrastructure, livestock identification and traceability, networking among crossborder communities and capacity building. ⁴¹⁷

As part of the ongoing effort to operationalize the signed MoU between Ethiopia and Somalia; in March 2025, joint planning for surveillance and vaccination calendar against TADs was conducted, along with the launch of a synchronized vaccination calendar. The initiative received funding from the Government of Switzerland under the Regional Livestock Program (RLP), with delegates from Ethiopia and Somalia reviewing the 2025 surveillance and vaccination calendar and planning for the 2026 joint cross-border vaccination; with a focus on operationalization of the implementation framework; engagement of cross-border partners in regional projects for improved coordination of TADs control; digital disease surveillance systems and ways to improve them. ⁴¹⁸

5.3.1a Biological and Toxin Weapons Convention status

Score: 50

Somalia is a signatory to, but has not ratified the Biological Weapons Convention (BWC).

According to the November 2024 'Meeting of the States Parties to the Convention on the Prohibition of the Development,Production and Stockpiling of Bacteriological(Biological) and Toxin Weapons and on Their Destruction', published by the United Nations Office for Disarmament Affairs, Somalia signed the Biological Weapons Convention (BWC) on 3 July 1972 but has not yet ratified or acceded to the treaty. ⁴¹⁹

5.3.1b Submission of CBMs to the Biological and Toxin Weapons Convention

Score: 0

Somalia has not submitted confidence building measures for the Biological Weapons Convention in the past three years.

According to the November 2024 'Meeting of the States Parties to the Convention on the Prohibition of the Development,Production and Stockpiling of Bacteriological(Biological) and Toxin Weapons and on Their Destruction', published by the United Nations Office for Disarmament Affairs, Somalia signed the Biological Weapons Convention (BWC) on 3 July 1972 but has not yet ratified or acceded to the treaty. ⁴²⁰

Therefore, Somalia has not submitted any confidence building measures for the Biological Weapons Convention.⁴²¹

5.3.1c Submission of UNSCR 1540 reports

Score: 0

Somalia has not provided the required United Nations Security Council Resolution (UNSCR) 1540 report to the Security Council Committee established pursuant to resolution 1540 (1540 Committee).

No evidence of a report being submitted by Somalia was found on the United Nations Security Council's webpage for 1540 National Reports. ⁴²²

5.3.1d Extent of UNSCR 1540 implementation on public health emergencies

Score: 0

5.3.2a Membership in global health security and/or biological weapons agreements

Score: 0

Somalia is not a member of any of the listed groups.

Somalia is not a member of the Global Partnership Against the Spread of Weapons and Materials of Mass Destruction ⁴²³, the Australia Group (AG) ⁴²⁴ or the Proliferation Security Initiative (PSI). ⁴²⁵

5.4.1a Completion and publication of JEE (or GHSA pilot external assessment) report

Score: 0

Somalia has not completed a Joint External Evaluation (JEE) or precursor external evaluation, nor published a full public report in the last five years.

Somalia underwent its first (and most recent) Joint External Evaluation (JEE) from 17–21 October 2016. The final report, titled Joint External Evaluation of the Republic of Malawi, was published by the World Health Organization (WHO) in 2017. ⁴²⁶

No evidence of a published or ongoing GHSA pilot external assessment was found on the Global Health Security Agenda's website.⁴²⁷

5.4.2a Completion and publication of PVS report (past five years)

Score: 100

Somalia has completed and published a Performance of Veterinary Services (PVS) assessment in the last five years.

The latest available Provisional Report titled 'Evaluation of the Performance of Veterinary Services' was published by the World Organization for Animal Health in October 2023. ⁴²⁸

5.4.2b Completion and publication of PVS gap analysis (past five years)

Score: 0

Somalia has not completed and published a Performance of Veterinary Services (PVS) gap analysis in the last five years.

According to the World Organisation for Animal Health webportal, a National Bridging Workshop (NBW) was conducted from 13-15 November 2023 in collaboration with the Ministry of Health, Somalia; Ministry of Livestock, Forestry and Range of Somalia; Ministry of Environment, Somalia; and Ministry of Agriculture and Irrigation, Somali. One of the key objectives of the NBW was to provide an opportunity to human health, animal health and environmental health services of the country to review their current collaboration gaps in key technical areas, and to develop a joint roadmap of corrective measures and strategic investments to strengthen the collaborative work at the animal-human-environment interface (pg. 11-12). ⁴²⁹

However, no evidence of a Performance of Veterinary Services (PVS) gap analysis being conducted was found on the webportal of World Organization for Animal Health. ⁴³⁰

5.5.1a Evidence of allocated national funds to improve capacity to address epidemic threats

Score: 100

There is public evidence that Somalia has allocated national funds to improve capacity to address pandemic or epidemic threats within the past three years.

In line with the Section 4.5 of Somalia's National Disaster Risk Management Policy (2022), a National Disaster Risk Management Fund (NDRMF) has been established with contributions from the Federal Government of Somalia (FGS), local organisations, businesses and international donors. The Fund will be managed by the Ministry of Humanitarian Affairs and Disaster Management (MoHADM) with oversight from the NDRMC. ^{431 432} Since the National Disaster Risk Management Policy explicitly includes 'epidemic outbreaks' categorised under 'non-specific hazards' in its list of Hazards; therefore the Fund is applicable for epidemics as well. (pg. 14)

According to the National Disaster Risk Management Policy, the NDRMF shall be allocated and utilised for the following purposes: implementation of disaster preparedness activities when there is a high probability of disaster; launching emergency/life-saving response; and short-term rehabilitation measures and planning of recovery/reconstruction activities. ⁴³³ The Stakeholder Engagement and Situational Analysis that underwent into the development of Somali Disaster Management Agency's (SoDMA) 'Strategic Plan 2024 -2029', has resulted in the incorporation of disease/pandemic preparedness into its disaster management plan (ie. Strategic Plan 2024 -2029), to enable effective responses to health emergencies (pg. 32). ⁴³⁴

5.5.2a National budget to address gaps identified in JEE, NAPHS or GHSA roadmap

Score: 0

There is no publicly available evidence that Somalia has allocated national budget to address the gaps identified in the JEE report.

Somalia underwent its first (and most recent) Joint External Evaluation (JEE) from 17–21 October 2016. The final report, titled Joint External Evaluation of the Republic of Somalia, was published by the World Health Organization (WHO) in 2017. Under it's section on 'Recommendations for priority actions', the report explicitly states that "there is no budget allocated by the Government to support IHR activities"(pg. 8). ⁴³⁵

A One Health National Bridging Workshop Roadmap was developed on 13-15 November 2023 in Nairobi, Kenya, attended by representatives from Somalia's Ministry of Health, Ministry of Livestock, Forestry and Range, Ministry of Environment and Ministry of Agriculture and Irrigation. Under its Objective 10, the Roadmap calls for "putting in place financial structures (MoU between National and State levels) to decentralize One Health budget from national to all levels." ⁴³⁶

No evidence of a published or ongoing GHSA pilot external assessment was found on the Global Health Security Agenda's website. ⁴³⁷ The Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) published by the Ministry of Health and Human Services in 2021 does not include any evidence of a national budget being allocated towards the gaps identified in the JEE report. ⁴³⁸

5.5.2b National budget to address gaps identified in PVS assessment or gap analysis

Score: 0

There is no evidence that Somalia's Performance of Veterinary Services (PVS) assessment allocate or describe specific funding from the national budget to address the identified gaps.

According to the October 2023 Provisional Report titled 'Evaluation of the Performance of Veterinary Services' published by the World Organization for Animal Health, "the Veterinary Services Department currently relies on externally sourced projects for funding, as there is no operational budget. There is also no emergency funding available" (pg. 3). No evidence of a budget allocation to address the identified gaps was found.⁴³⁹

5.5.3a Emergency public financing during a public health emergency

Score: 100

There is publicly available evidence that Somalia has a special emergency public financing mechanism and funds which the country can access in the face of a public health emergency.

The World Bank through Project 'Damal Caafimaad' (P178876) in March 2024 has approved an additional Grant from the Green Climate Fund (GCF) in the amount of USD 4.25 million to the Federal Republic of Somalia for the Improving Healthcare Services in Somalia. The project includes a Contingent Emergency Response Component (CERC) mechanism, which allows Somalia to quickly access reallocated project funds during public health emergencies. ⁴⁴⁰

The National Disaster Risk Management Policy (2022) under Section 4.5 calls for the establishment of a National Disaster Risk Management Fund (NDRMF), with contributions from the Federal Government of Somalia (FGS), local organisations, businesses and international donors. The Fund will be managed by the Ministry of Humanitarian Affairs and Disaster Management (MoHADM) with oversight from the NDRMC. ⁴⁴¹ As of September 2025, the NDRMF is functional and a Director of the National Disaster Risk Management Fund has been appointed by the Commissioner of the Somali Disaster Management Agency (SoDMA). ⁴⁴²

According to the National Disaster Risk Management Policy, the NDRMF shall be allocated and utilised for the following purposes: implementation of disaster preparedness activities when there is a high probability of disaster; launching emergency/life-saving response; and short-term rehabilitation measures and planning of recovery/reconstruction activities. ⁴⁴³ The Stakeholder Engagement and Situational Analysis that underwent into the development of Somali Disaster Management Agency's (SoDMA) 'Strategic Plan 2024 -2029', has resulted in the incorporation of disease/pandemic preparedness into its disaster management plan, to enable effective responses to health emergencies (pg. 32). ⁴⁴⁴

Proposals for funds may be submitted by line departments of the Federal Government of Somalia, State State Disaster Risk Management Authority (DRMA), or similar Competent Authority of a State government, which will be vetted by MoHADM before recommending these to NDRMC for approval. Then, in consultation with the Office of National Auditor, MoHADM will develop financial reporting and audit procedure that will be applicable to this Fund, and ensure that audited reports of financial utilisation and compliance are submitted to the NDRMC periodically which, in turn, will make these reports showing allocation and expenditure available to public and donors (pg. 44).⁴⁴⁵

5.5.4a Commitments to improve domestic or foreign capacity for epidemic threats

Score: 0

There is insufficient evidence that Somalian ministers have requested support to improve the country’s domestic capacity to address pandemic or epidemic threats, and no evidence of Somalian ministers making a public commitment to provide support to other countries.

According to an August 2023 case study published by the World Health Organisation (WHO), Somalia in collaboration with Food and Agriculture Organization (FAO), WHO and United Nations Children's Fund (UNICEF), has submitted a proposal for the pandemic fund call in April 2023 to build coordinated One Health capacities in surveillance, laboratories and health workforce (pg. 12). ⁴⁴⁶

According to an independent Budget analysis by Somali Public Agenda in May 2025, the Ministry of Health and Human Services has received a notable boost, with its budget allocation growing from USD 52 million in 2024 to USD 91 million in 2025, $39 million increase. However, the increased budget allocation is primarly aimed at addressing Somalia’s healthcare challenges, particularly maternal and child health. ⁴⁴⁷

No further evidence of public commitments was found via the Ministry of Foreign Affairs & International Cooperation ⁴⁴⁸ and Ministry of Health and Human Services' Facebook page. ⁴⁴⁹ The Ministry of Health and Human Services's website was inaccessible at the time of research. ⁴⁵⁰

5.5.4b Investments to improve domestic or foreign capacity for epidemic threats

Score: 100

There is evidence that Somalia has requested financing or technical support from donors to improve the country’s domestic capacity to address epidemic threats., however there is no evidence of Somalia financing or technical support to other countries.

According to an August 2023 case study published by the World Health Organisation (WHO), Somalia in collaboration with Food and Agriculture Organization (FAO), WHO and United Nations Children's Fund (UNICEF), has submitted a proposal for the pandemic fund call in April 2023 to build coordinated One Health capacities in surveillance, laboratories and health workforce (pg. 12). ⁴⁵¹

The Global Health Security (GHSA) Funding Tracker Dashboard, last updated in 2022, indicates that as of 2022, Somalia had not invested finances or technical support to support other countries to improve their capacity to address epidemic threats.⁴⁵²

No further evidence of public commitments was found via the Ministry of Foreign Affairs & International Cooperation ⁴⁵³ and Ministry of Health and Human Services' Facebook page. ⁴⁵⁴ The Ministry of Health and Human Services's website was inaccessible at the time of research. ⁴⁵⁵

5.5.4c Evidence that the country has fulfilled its full WHO contribution within the past two years

Score: 0

There is public evidence that Somalia has not fulfilled its full contribution to the WHO within the past two years.

According to the latest Assessed contributions overview published by the World Health Organization on 9 May 2024, Somalia has an outstanding balance USD 9,570 for the year 2023, and a total outstanding balance of USD 447,966. ⁴⁵⁶

5.6.1a Sharing of genetic/biological data and materials beyond influenza

Score: 0

There is insufficient evidence that Somalia has a publicly available plan or policy for sharing genetic data, epidemiological data, clinical specimens, and/or isolated specimens (biological materials) with international organizations and/or other countries that goes beyond influenza.

Somalia is part of the World Health Organisation (WHO)'s Early Warning, Alert, and Response Network (EWARN), an ongoing surveillance system involving weekly reporting of public health issues. According to a 29 March 2018 WHO article the, "EWARN relies on a network of health facilities, and public health professionals who are responsible for the collection, reporting, investigation, analysis and dissemination of information to stakeholders to implement effective public health response measures." However, it is unclear if this includes genetic data, epidemiological data, clinical specimens, and/or isolated specimens (biological materials). ⁴⁵⁷

No evidence of a plan for sharing genetic data, clinical specimens, and/or isolated specimens (biological materials) was found in the Somalia Health Sector Strategic Plan 2022–2026 (HSSP III) released by the Ministry of Health and Human Services in December 2021. ⁴⁵⁸

The Ministry of Agriculture and Irrigation's website do not discuss this issue. ⁴⁵⁹, and at the time of research, the website of Somalia's Ministry of Health and Human Services was inaccessible. ⁴⁶⁰

5.6.1b Evidence of non-compliance with sample sharing element of PIP framework

Score: 100

There is no public evidence that Somalia has not shared samples in accordance with the Pandemic Influenza Preparedness (PIP) framework in the past two years.

According to the latest available Six-month progress report published by the World Health Organisation on the Pandemic Influenza Preparedness Framework for the timeframe 1 January-30 June 2024, Somalia has contributed to both Output 1 'Pandemic Planning' as well as Output 2 'Collaborative Surveillance' to the PIP Framework Partnership Contribution High-level Implementation Plan (HLIP) III. (pg. 33). ⁴⁶¹

Additionally, no evidence of non-compliance was found through the World Health Organisations' "News Room"⁴⁶², country page for Somalia ⁴⁶³ or "Disease Outbreak News (DON)" ⁴⁶⁴, or local and international media outlets. ^{465 466}

5.6.1c Evidence of non-sharing of pandemic pathogen samples during an outbreak

Score: 100

There is no publicly available evidence that Somalia has not shared pandemic pathogen samples during an outbreak in the past two years.

No evidence on this was found through the World Health Organisation's country webpage for Somalia ⁴⁶⁷ nor local or international news media outlets. ^{468 469}

At the time of research, the website of Somalia's Ministry of Health and Human Services was inaccessible. ⁴⁷⁰

6.1.1a Policy formation

Score: 25

6.1.1b Quality of bureaucracy

Score: 0

6.1.1c Excessive bureaucracy/red tape

Score: 0

6.1.1d Vested interests/cronyism

Score: 0

6.1.1e Corruption

Score: 9

6.1.1f Accountability of public officials

Score: 0

6.1.1g Human rights risk

Score: 0

6.1.2a Orderly transfers of power

Score: 0

6.1.3a Risk of social unrest

Score: 0

6.1.4a Risk of terrorism

Score: 0

6.1.4b Level of illicit arms flows within the country

Score: 50

6.1.4c Risk of organized criminal activity

Score: 0

6.1.5a Presence or risk of armed conflict

Score: 0

6.1.6a Government territorial control

Score: 0

6.1.7a International tensions

Score: 0

6.2.1a Adult literacy rate (15+ years old, both sexes)

Score: 57.17

6.2.2a UNDP Gender Inequality Index score

Score: 0.46

6.2.3a Poverty gap at $1.90 a day (2011 PPP) (%)

Score: 0

6.2.3b Share of employment in the informal sector

Score: 0

6.2.3c Coverage of social insurance programs (% of population)

Score: 0

6.2.4a Public confidence in government

Score: 0

6.2.5a Robust, open, diverse local media and reporting

Score: 0

6.2.6a Gini coefficient

Score: 0

6.3.1a Adequacy of road network

Score: 0

6.3.2a Adequacy of airports

Score: 0

6.3.3a Adequacy of power network

Score: 0

6.4.1a Urban population (% of total population)

Score: 56.19

6.4.2a Change in forest area (percentage points)

Score: 61.87

6.4.3a Natural disaster risk

Score: 0

6.5.1a Total life expectancy (years)

Score: 19.75

6.5.1b NCD mortality rate

Score: 34.84

6.5.1c Population aged 65+

Score: 94.43

6.5.1d Tobacco use (% of adults)

Score: 0

6.5.1e Level of adult obesity (%)

Score: 94.47

6.5.1f Age-standardised prevalence of mental health disorders (per 100 000 people)

Score: 46.2

6.5.2a Access to potable water

Score: 74.96

6.5.2b Access to at least basic sanitation facilities

Score: 43.92

6.5.2c Percentage of health-care facilities with no access to any electricity supply

Score: 56.25

6.5.3a Domestic general government health expenditure per capita (PPP)

Score: 0

6.5.4a Trust medical and health advice from the government

Score: 50

6.5.4b Trust medical and health advice from medical workers

Score: 50