In Somalia, long-lasting insecticidal mosquito nets are one measure used to keep mosquitoes away. Credit: WHO/Somalia

24 April 2022 – On 25 April 2022, World Malaria Day will be commemorated under the theme “Harness innovation to reduce the malaria disease burden and save lives.” Recognizing that the world needs a suite of approaches and tools to reduce the prevalence of malaria, WHO is calling for investments and innovation that bring new vector control approaches, diagnostics, antimalarial medicines and other tools to speed the pace of progress against malaria.

Prevalence in Somalia

In Somalia, malaria is endemic across the country, particularly in the south and central parts of the country.  In 2021, the country confirmed 8101 malaria cases and 2 related deaths, which was a remarkable reduction compared to 31 021, 22 665 and 27 333, in 2018, 2019 and 2020, respectively, owing to the impact of the malaria control programme supported by WHO in the country.

The national malaria programme in Somalia did not observe any significant negative impact on malaria activities in 2020 due to the COVID-19 pandemic – the programme ran 253 172, 217 206, 337 965 and 295 475 malaria tests in 2018, 2019, 2020 and 2021, respectively. Despite this, joint urgent action is required to meet the 2030 targets outlined in the WHO global malaria strategy.

Malaria control

The malaria control programme in Somalia relies on early testing and identification of cases, effective case management using the right anti-malarial drugs, and distribution of insecticide-treated bed nets and indoor residual spraying (IRS) for preventing mosquito bites.

In Bossaso, 52-year-old Sahra Yusuf Ali, had a headache, fever, vomiting and joint pain. On visiting a local health facility, she was diagnosed with malaria after she took a rapid diagnostic test.

Sahra expressed her gratitude to the Ministry of Health, UNICEF and WHO, and the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) for their support to health facilities. It was thanks to their support that Sahra could get tested and treated with antimalarial drugs. After her experience, Sahra requests Somali communities to clean all sources of mosquitoes, use insecticide-treated nets and get tested as soon as they have symptoms of malaria, to avoid complications.   

Acknowledging the support that partners have lent malaria reduction efforts, Dr Mamunur Malik, WHO Representative said, “We would like to thank the federal and state governments of Somalia, UNICEF, the GFATM and other partners for their collaboration in controlling and eliminating malaria. In line with the theme for World Malaria Day this year though, we collectively need to think critically about how to use innovative approaches and tools to test for malaria and prevent any additional cases of malaria.”

The Federal Government of Somalia, in collaboration with WHO Somalia and partners, have developed ‘Guidelines for the Diagnoses and Treatment of Malaria in the Somali Context 2016’ to help health personnel manage malaria cases and identify symptoms in a timely manner. They have also introduced malaria elimination activities in targeted districts. 

WHO works with the government and partners to strengthen the skills of health workers, to improve surveillance for and management of malaria cases. Credit: WHO/Somalia

Modifying berkits to reduce larva in Bossaso 

In 2017, the national malaria control programme conducted an assessment to determine the main factors contributing to the malaria burden in Somalia. This assessment found that manmade berkits or well-like containers used to store water, made of mud or cement, accounted for 89% of breeding sites for mosquitoes.

Additionally, the malaria control programmes in Puntland and Somaliland found that the Anopheles stephensi vector found in Bossaso in 2019 and in Berbera and Hargeisa in 2020 were breeding in the berkits, which shows the malaria burden in Somalia has been magnified due to this method of water storage.

As next steps, in January 2021, the national malaria control programme, with support from WHO and funding from GFATM through UNICEF, implemented a pilot project as a larval source management effort, to modify 200 berkits in Bossaso, which are ubiquitous due to the limited piped water supply in the city. The programme covered the sides of the containers permanently to shield stagnant water from mosquitoes.   

After 12 months of the project, between December 2021 and January 2022, an assessment was conducted in 132 households in two locations in Bossaso city, one where berkits had been modified, and another where no modifications were made. A screening conducted in both districts noted a four-fold reduction in malaria positivity rate in the district where berkits had been modified to keep mosquitoes out.

Noting this success, this assessment recommended that this larval source management intervention should be extended to other villages and cities affected by malaria.

WHO supported the federal and state governments to resume routine childhood vaccinations during the COVID-19 outbreak in Somalia. Credit: WHO/Somalia

23 April 2022, Mogadishu – While marking World Immunization Week this year, Somalia’s Federal Ministry of Health and Human Services, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) jointly urged humanitarian partners, local private agencies and donors to help boost immunization efforts and outreach across Somalia. This message is in line with the theme for World Immunization Week, 2022, running from 24 to 30 April, which is ‘Long life for all – in pursuit of a long life well lived.’

World Immunization Week 2022 aims to spur greater engagement around immunization globally, to reiterate the importance of vaccination and improve the health and well-being of everyone, everywhere.

In line with this global call and taking into account only 9% of Somalis have been fully vaccinated against COVID-19, Dr Fawziya Abikar Nur, Minister of Health, the Federal Government of Somalia said, “In 2020, the world witnessed a pause on many health services due to the COVID-19 pandemic. By producing vaccines at record speed, alongside other measures, we have now seen how life is resuming slowly again. However, in developing countries, such as Somalia, the majority of the population still remains to be vaccinated. They are still at risk, and we cannot emphasize enough – we must reach everyone, wherever they live, to stop diseases such as COVID-19 from mutating and circulating.”

“Vaccines are one of the greatest success stories of public health. And yet, with all the knowledge and tools we have, Somali children are still contracting vaccine-preventable diseases, and adults are still being infected with diseases such as COVID-19.  It is our moral imperative to ensure every Somali has equitable access to vaccinations and a life free of disease and disabilities. We must all join forces to reach more people with life-saving vaccines,” said Dr Mamunur Rahman Malik, WHO Somalia Representative and Head of Mission, while describing how the advent of smallpox vaccines showed the world that it is possible to eradicate diseases if governments and all stakeholders join forces.

A child from an internally displaced camp receiving measles vaccines during a measles outbreak investigation, Garowe, Puntland. Credit: WHO/Somalia

“It’s vital that parents and caregivers take control of their children’s health by making sure every child gets their routine vaccinations,” said UNICEF Representative a.i., Angela Kearney. “Vaccines ensure protection against preventable diseases and a healthier life. Vaccines are free and it’s the right thing to do.”

Somalia has an estimated 639 000 children aged under one year, but many are not able to access their regular childhood vaccinations. In 2021, 510 951 children received the third dose of penta vaccines to protect them from pertussis, diphtheria, hepatitis B, tetanus and Haemophilus influenzae type b, while around 80% of all measles cases confirmed in 2021 were children aged under 5.

Some of the challenges Somalia faces in ensuring all communities have access to vaccinations include a fragile health system, further impeded by conflict and natural disasters, including the ongoing drought, limited access to cold chain facilities in remote areas and among hard-to-reach populations, and difficulty in reaching people living in insecure and inaccessible locations.

A medical expert visits a household in Jubaland to assess a measles outbreak and offer vaccines to children. Credit: WHO/Somalia

Over the years, WHO, UNICEF, and partners and donors have extended support to Somalia in developing mechanisms to store various vaccines and establish community vaccination programmes that resulted in vaccinating communities. Despite all the challenges, Somalia has indeed had some success in getting more children and adults, particularly vulnerable ones, vaccinated against vaccine-preventable diseases such as measles, cholera, polio, diphtheria, tuberculosis, pertussis, tetanus, Pneumococcal conjugate vaccine (PCV) and COVID-19 disease, using strategies such as mobile outreach sessions in addition to fixed vaccination sites. Additionally, teams of health care workers and social mobilizers, supported by the Government, WHO and UNICEF, are regularly visiting communities to share messages on the benefits of vaccination with them.

However, the country needs more support to protect children and adults, particularly vulnerable ones, from vaccine-preventable diseases.

For additional information, please contact:

Khadar Hussein Mohamud, Head of Coordination and Communications, Ministry of Health, Federal Government of Somalia,  This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Mukhtar Abdi Shube, Head of the Expanded Programme on Immunization (EPI) section, Ministry of Health, Federal Government of Somalia, This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Fouzia Bano, Communications Officer, WHO Somalia, This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Victor Chinyama, Chief of Communications, UNICEF Somalia, This e-mail address is being protected from spambots. You need JavaScript enabled to view it

27 March 2022 - World Tuberculosis (TB) Day, commemorated on 24 March every year, aims to increase awareness about the grave health, social and economic consequences of TB, and scale up efforts to prevent further spread of the disease. The theme for this year is to ‘Invest to End TB. Save Lives’.

TB is a major cause of death and disease burden in Somalia. The 2021 Global TB Report indicated there was a marginal increase in the estimated TB incidence in Somalia, from 258 per 100 000 people in 2018 to 259 per 100 000 in 2020. However, the death rate in Somalia remained at 68 per 100 000.

Effects of COVID-19 on the TB programme

Reporting cases and addressing them in a timely manner is crucial in stopping the spread of TB. However, the minimal increase in the number of cases reported in Somalia in 2020 and the plunge in global TB notification, which went from 7.1 million in 2019 to 5.8 million in 2020, can be attributed largely to the COVID-19 pandemic. The global death rate also increased in the same period, as people worldwide refrained from visiting health facilities due to a fear of being infected with COVID-19.

In 2020, an estimated 1.3 million HIV negative people died of TB, up from 1.2 million in 2019, while an additional 214 000 HIV positive people died. Of the cases reported in 2021, 17 204 were drug-sensitive cases, while 299 were drug-resistant cases.

“Somalia’s TB programme is now gradually recovering from the effects of the COVID-19 pandemic though, with 17 503 TB cases notified in 2021, as compared to 17 200 reported in 2020,” said Dr Abdiaziz Mohamud Shire, National TB Programme Manager, Federal Ministry of Health and Human Services. “Even though we are making progress, we still need more support in the form of GeneXpert machines and outreach activities. Both are important for case detection.”

Limited awareness and incorrect diagnosis

Despite its prevalence, health personnel are still missing the mark in terms of timely diagnoses, and people like Adow Adan Abdi are still unaware of the symptoms of TB. Around a year-and-a-half ago, Adow began to cough a lot but thought he probably had a simple cold. At a clinic in Tiyeglow, the doctors gave him antibiotics and syrup for the cough, but only after two weeks of visits. On seeing no improvement, they referred Adow to a private clinic in Baidoa, Bay region, to run blood tests, where they confirmed he had TB and prescribed medication as treatment. Adow had to buy it himself though.

For the first four months, the symptoms decreased, but during the fifth month, Adow returned to Tiyeglow as his cough was back. He lost his appetite and lost more weight. His situation deteriorated and he even began to cough blood and pus. When Adow became severely ill, his family took him to the Manhal TB centre in Waberi, Mogadishu, for support. They took a sample of sputum and tested it, and then referred him to the Forlanini Multi-drug-resistant-Tuberculosis (MDR-TB) Centre for treatment, where he finally received the right attention.

Adow, who is still in the Forlanini Hospital for now, is relieved that his medication, along with counselling, are helping him. He has even made good friends with the hospital staff, whom he says are very helpful, and with other patients recovering from TB. They have their meals together and discuss their experiences, which has helped him feel much better.

After three months of treatment, Adow is starting to gain weight. Even though he feels ready to leave, the hospital staff have requested him to stay on until his joint inflammation reduces.

Adow says he feels more people need to know that TB is curable and can be prevented. He is grateful that agencies such as WHO are supporting health facilities with modern testing equipment for TB, and requests decision-makers to consider supporting TB patients with nutrition.

New technology being used for TB testing

WHO has supported the Federal and State Ministries of Health in Somalia to use rapid molecular diagnosis as the primary tool for TB diagnosis. In 2021, half of all presumptive TB cases in Somalia had access to GeneXpert testing, while 61% of all sputum smear-positive cases were diagnosed using GeneXpert tests.

In 2021, Somalia had 99 Tuberculosis Management Units (TBMUs) and 50 GeneXpert machines distributed across the country. Twenty-two GeneXpert machines were used in the diagnosis for both TB and COVID-19. The three MDR-TB centres in Mogadishu, Hargeisa and Galkayo treating multi-drug resistant TB operated normally with no major challenges reported. The culture laboratories in Hargeisa and Mogadishu continued to perform Line Probe Assays 1 and 2 (LPA 1 & 2), to detect mycobacterium tuberculosis and drug resistance, under the supervision of the Uganda Supranational Reference Laboratory.

In 2021, 89% of the TB cases in Somalia were tested for HIV co-infection. Of these, only 0.9% were found to be co-infected. The Ministry of Health, WHO HIV Team, and UNICEF provided around 64% of the TB cases with co-infections access to antiretroviral treatment (ART) to help treat HIV.

Collaboration from partners

“Our investments so far have reaped double benefits by saving lives by testing for both TB and COVID-19,” said Dr Mamunur Rahman Malik, WHO Representative to Somalia and Head of Mission. “By further scaling up our investments in TB prevention, we can ensure all Somalis, everywhere, know more about how TB is spread, and have equitable access to prevention and care. This will help us to reach Universal Health Coverage.”

The Global Fund supports the TB elimination programme in Somalia financially through World Vision International, which is the principal recipient of funding. International and local nongovernment organizations run the TB centres as sub-recipients of the Global Fund TB grant, while the independent monitoring body monitors the entire programme. The TB Coordination Team that brings together the national TB programme (NTP), WHO, World Vision International and major implementing partners continues to be the decision-making body of the programme. It reviews TB elimination activities twice in a year to address any challenges that the programme faces.

As the technical organization supporting the national TB programme, WHO supports capacity development, drug management, development of treatment guidelines and reporting materials, and data management, and guides the World Vision in the implementation of strategies.

NAIROBI, 22 March 2022 – Yesterday, the Federal Government of Somalia, World Health Organization (WHO) and members of the Global Polio Eradication Initiative (GPEI) recommitted to stopping the ongoing outbreak of circulating poliovirus type 2 (cVDPV2) in Somalia at a three-day meeting convened in Nairobi, Kenya. High-level delegates at the meeting included HE Fawziya Abikar Nur, Federal Minister of Health and Human Services, Dr Mamunur Rahman Malik,

WHO Representative to Somalia and Head of Mission, alongside senior representation from the Bill & Melinda Gates Foundation (BMGF), the Centers for Disease Control and Prevention (CDC), Rotary International, Save the Children, the United Nations Children’s Fund (UNICEF), and other UN agencies and partners.

Together, the Government, GPEI partners, which include WHO, UNICEF, the BMGF, CDC, Rotary International, GAVI, the Vaccine Alliance, and other key partners endorsed the Somalia Polio Eradication Action Plan 2022 to reaffirm their commitment.

The Somalia Polio Eradication Action Plan 2022 outlines a four-point call to action to stop the spread of the current outbreak, which is one of the longest lasting cVDPV2 outbreaks to be reported so far. The robust plan aims to direct partners’ efforts and resources towards boosting population immunity, making concerted efforts to reach high-risk populations — including inaccessible and nomadic communities and internally displaced persons — to strengthen their immunity, enhancing the search for poliovirus circulation, and strengthening coordination among all stakeholders. Some of the strategies that will be deployed include intensifying efforts to offer 5 opportunities for vaccination against polio in 2022, providing routine childhood immunization in high-risk locations, where children have missed out on vaccinations, and strengthening community engagement. Given how easy it is for the cVDPV2 virus to spill over international borders, the emergency plan also advocates for stronger cross-border coordination among the polio eradication programmes in Somalia, Kenya, Ethiopia and Djibouti.

“In the midst of the ongoing drought, and while recovering from the effects of the COVID-19 pandemic, our stakeholders must not forget how important it is to contain the ongoing poliovirus outbreak so that it does not spread any further and does not affect any more children’s lives,” said HE Fawziya Abikar Nur, Federal Minister of Health and Human Services. “On this occasion, I would like to extend my sincere gratitude to all our partners, and donors, for the immense efforts they have put into shielding millions of Somali children from polio over the years.”

“Since its inception 25 years ago, Somalia’s polio eradication programme has made progress, including by stopping outbreaks of wild poliovirus and, recently, one of circulating poliovirus type 3 in 2021. The programme has established a vast network of polio workforce and assets and we can do more not only to stop the current outbreak but to achieve broader health system goals through integration and effective use of our human and operational resources. Since 2018, Somalia has conducted several supplementary immunization campaigns. Despite these efforts, pockets of unvaccinated children remain, due to insecurity and limited access to health services,” said Dr Mamunur Rahman Malik, WHO Representative to Somalia.

The Somalia Polio Eradication Action Plan, which will be implemented in 2022, complements one of the goals outlined in the GPEI ‘Polio Eradication Strategy 2022–2026: Delivering on a Promise’, to stop cVDPV transmission and prevent outbreaks in non-endemic countries. It is also in line with Somalia’s national goals and UN Sustainable Development Goals (SDGs).

For additional information, please contact:

Khadar Hussein Mohamud
Head of Coordination and Communications, Ministry of Health
Federal Government of Somalia
This e-mail address is being protected from spambots. You need JavaScript enabled to view it  

Fouzia Bano
Communications Officer
WHO Somalia
This e-mail address is being protected from spambots. You need JavaScript enabled to view it