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Commemorating Zero Discrimination Day: reducing stigma against HIV/AIDS
Laboratory workers conduct blood testing in Hergeisa, Somaliland. Photo credit: WHO Somalia/Fouzia Bano
Mogadishu, 01 March 2023 – On Zero Discrimination Day (1 March), which is organized annually by UNAIDS to combat HIV/AIDS-related discrimination, WHO Somalia stands in solidarity with people living with HIV/AIDS. In 2023, the theme for the day is “Save lives: decriminalize”. While the Somali government, in partnership with WHO and other stakeholders, has made great strides in reducing the prevalence of HIV, stigma and discrimination remain and must be addressed.
WHO’s HIV/AIDS work in Somalia focuses on building the capacity of the health system to offer HIV testing, counselling and treatment, including antiretroviral therapy (ART), and conducting regular monitoring and modelling to understand the burden of HIV in the country. Despite challenges of accessibility, ongoing drought and insecurity, programme data show significant progress against HIV/AIDS. By the end of December 2022, 4100 patients were receiving ART. Some had been on the treatment since 2005 when the service was first opened in the country. Other treatment quality programme indicators show commendable performance, with Somalia holding its own in comparison with immediate neighbours, and other countries in the Region.
However, stigma and discrimination remain a major constraint. Many newly diagnosed patients avoid enrolling for treatment for fear of public stigma or enrol at distant facilities where they are unknown, jeopardizing longer term treatment adherence.
In 2022, WHO and state Ministries of Health undertook a study to examine causes for defaulting and deaths among patients on ART. Using the patients’ phone numbers on file, the study managed to reach almost a fifth of the 712 patients who had defaulted and stopped their treatment since ART first started in the country. Stigma was the number one reason given for defaulting on treatment, and was cited by 1 in 5 respondents.
Reasons for defaulting on ART
Restrictive laws and societal stigma also limit the ability of HIV/AIDs prevention and treatment programmes to reach key populations most at risk.
WHO’s Medical Officer for HIV/AIDS Dr William Rogers Busulwa said, “New data is emerging that despite the declining trends in the general population, the same decline has not been seen among key population groups who are at particular risk of contracting HIV. In fact, with limited research, it is difficult to assess the true burden of HIV within key populations – and in a context with limited resources, restrictive laws and significant stigma associated with HIV/AIDs, filling these research gaps is highly challenging. This year, a new study established for the first time that there are significant numbers of injecting drug users in the country[1]. Efforts to understand and address HIV/AIDS in Somalia must not be allowed to slacken, but rather geared up.”
WHO, alongside the Ministries of Health, AIDS Commissions, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and other partners, has supported public advocacy activities to reduce stigma and promote health for all. In its work with health facilities and communities, WHO emphasises confidentiality and has included content against stigma and discrimination in HIV counselling, testing and treatment training. However, broader societal stigma and restrictive laws impede progress against HIV/AIDS and it is clear that more efforts are needed to ensure that all Somalis can access essential, lifesaving health services free from stigma and discrimination.
WHO extends its appreciation and thanks to the Global Fund to Fight AIDS, Tuberculosis and Malaria, which has contributed US$ 2 433 300 since 2018 to support WHO’s work against HIV/AIDS in the Somali states.
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For additional information, please contact:
Kyle DeFreitas
External Relations Officer
Fouzia Bano
Communications Officerr
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[1] FGoS /ACHESEREM. Mapping and size estimation of key vulnerable populations in Somalia, February 2023.
Somalia calls for help as 1.8 million Somali children under 5 experience acute malnutrition and health complications
A mother and a child await their turn for medical attention, as WHO outreach team provides life-saving services in a remote district of Puntland. Credit: WHO Somalia
WHO utilizes CERF funds to minimize health impact of drought
Mogadishu, 1 March 2023 – A rapidly evolving drought and famine-like situation in Somalia continue to affect 7.8 million people and has already resulted in displacing 1.4 million,while putting the lives of more than 1.8 million under 5 children at risk of severe malnutrition and related health complications.
The WHO Country Office, with the funding from Central Emergency Response Fund (CERF), has scrambled all its ground resources to halt a catastrophe from happening by providing hope and resilience to distressed populations through provision of essential lifesaving primary health care services in 31 hard-hit districts across the country. However, experts believe that situation is getting worse and that the international community should pay greater attention by extending their support to avoid a calamity and repeat of the 2011–2012 famine in which more than 260 000 lives were lost due to prolonged drought and a famine – the worst in its history.
“CERF funding has certainly helped us keep morbidity and mortality to a minimum, but with rapid and increased displacement of populations and liberation of previously inaccessible districts, the situation may spiral out of hand in the coming weeks and months. Our planned intervention targets are becoming bigger by the day because of the increased demand both at health facilities and outreach sites across the country. It’s time that the world should open up their coffers to help Somali populations cope with one of the worst droughts in more than a decade,” commented the WHO's acting Incident Manager, Khalid El-Tahir who is leading drought response activities in Somalia.
Since July 2022, WHO, has used the CERF funding as a catalyst to spearhead health interventions reaching 724 525 vulnerable people with emergency health care services by procuring and distributing essential medical lifesaving equipment, medicines, and supplies to 57 health facilities in target areas, including support to 7 laboratories with essential laboratory items for timely detection of diseases with epidemic potential and response activities.
The Central Emergency Response Fund is a humanitarian fund established by the United Nations General Assembly on 15 December 2005 and launched in March 2006. CERF’s objectives include promoting early action and response to reduce loss of life, enhance response to time-critical requirements and strengthen core elements of the humanitarian response in underfunded crises. CERF seeks to enable timelier and more reliable humanitarian assistance to those affected by natural disasters and armed conflicts. The fund is replenished annually through contributions from 125 Member States and more than 30 private and regional donors.
Currently, Somalia is experiencing multiple emergencies at the same time with rising incidence of diseases that are preventable. To meet the growing demand from the target districts, WHO has scaled up its emergency drought response operations massively, yet the need is outstripping the supplies.
CERF-enabled drought response
There is a continued sharp increase in the number of people requiring urgent support, it is estimated that approximately 1.8 million children under 5 might face acute malnutrition until June this year, which represent 54.5% of the total children population in the country. Of whom, 513 550 are estimated to be severely malnourished. The median prevalence of severe acute malnutrition has also worsened from 1.5% in 2021 Gu and 2.1% in 2021 Deyr to 3.1% in 2022 Gu. Humanitarian cluster partners in Somalia are reporting that almost half of Somalia’s 15.7 million population has been affected by the current drought and over 1.9 million people have left their homes in search for food, water, and livelihoods.
WHO supported public health interventions provided through both the fixed health facilities and through outreach teams in the communities has managed to consult, treat, immunize and refer. Since the beginning of last year, WHO has reached close to 7.7 million people (including women and people with disabilities) in the 31 drought-affected districts with health care. Acute food insecurity has continued to worsen across Somalia, with an estimated 7.8 million people across Somalia experiencing high levels of acute food insecurity (IPC Phase 3 or above), including 4.7 million facing crisis (IPC Phase 3), 2.1 million people facing emergency (IPC Phase 4) and more than 213 000 facing catastrophe (IPC Phase 5). Rates of stunting are also higher than the last decade by 28%.
“If the situation is not addressed the future of Somali children is jeopardized as stunting in children is associated with an increased risk of mortality, reduced cognitive development, reduced adult income earning capacity,” warned WHO Somalia’s Health Operation Manager, Simon Kaddu Ssentamu.
WHO-supported outreach activities are proving beneficial as front-line health workers bring health services to the doorsteps of local communities and displaced people. Credit: WHO Somalia
Under the ongoing CERF-funded interventions, WHO has deployed 372 vaccinators, 2137 community health workers and mobilizers across 31 drought-affected districts and have reached over 7 million at-risk population with preventive and promotive health interventions, vaccinating 905 229 children (6 months to 5 years of age), administering vitamin A supplementation and/or micronutrient supplements to 152 202 children (6 months to 5 years), deworming 133 703 children (12-59 months) and generating 2350 health-related alerts for investigations during the last 3 months and supporting 281 health facilities across affected districts. WHO teams have surpassed the initial targets of interventions by almost 50% due to continued surge of populations from recently liberated areas towards settled districts.
The community health workers besides referring critical patients to health facilities also delivering key messages for reproductive health services, including family planning and child spacing, screened and referred children to the OTP/stabilization centre and providing supplementation with micronutrients to pregnant women. The community health workers were also trained on identification and referral of cases of gender-based violence for additional support.
For additional information, please contact:
Kyle DeFreitas
WHO Somalia External Relations Lead
Fouzia Bano
WHO Somalia Communications Officer, Chief of Staff ai
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Weekly cholera situation report
Japan and WHO officially launch project to provide emergency medical assistance to 2.7 million people in 29 drought-affected districts in Somalia
H.E. Ken Okaniwa, Ambassador of Japan to Somalia and WHO Representative Dr Mamunur Rahman Malik
Nairobi, 22 February 2023 – The World Health Organization (WHO) Somalia Country Office and the Government of Japan have joined hands and officially launched a drought emergency response project that aims to reach over 2.7 million people across 29 drought-affected districts with critical health interventions.
The project, entitled “Expanding access to essential and emergency health care for the drought-affected communities living in hard-to-reach areas in Somalia”, will not only contribute to improving access to critical and life-saving health and nutrition services, it will also build resilience of primary health care system in the country towards achieving universal health coverage (UHC). The launch ceremony was hosted by H.E. Ken Okaniwa, Ambassador of Japan to Somalia, in the presence of the WHO Representative to Somalia Dr Mamunur Rahman Malik.
This funding from the Government of Japan, under the Japanese supplementary budget for 2023, is coming at an important time as Somalia is experiencing one of the worst droughts in its history. More than 7.8 million people have been affected by the worsening drought conditions, and an estimated 1.8 million children face severe acute malnutrition. Indeed, this support will enable WHO, as well as Federal and State-level Ministries of Health to reach the most vulnerable populations with emergency health care services, including those who are internally displaced and severely impacted by the drought.
“The people and Government of Japan remain committed to supporting the people of Somalia, especially at a time when more than 70% of the population are not only facing severe food insecurity, but the lives of more than half of the country’s children under 5 years of age are at stake owing to the possibility of disease outbreak, malnutrition and famine. We are confident that our partnership with WHO will help to avert this situation, while simultaneously helping to strengthen Somalia’s health system and progress towards UHC,” said H.E. Ken Okaniwa, Ambassador of Japan to Somalia.
Over a one-year period, this project will help to expand community-based and integrated health and nutrition interventions (especially to children, pregnant and lactating women, and internally displaced persons), strengthen disease surveillance, improve service delivery at the district level by equipping health care units, and establish referral linkages between communities and primary healthcare facilities for enhanced quality and continuity of care, thereby helping to reduce preventable morbidity and mortality among vulnerable communities. WHO will achieve this by deploying over 2100 community health workers and establishing 148 mobile outreach teams to increase access to life-saving services at the community level, as well as by establishing and supporting 64 stabilization centres at health facilities to treat children with severe acute malnutrition with medical complications, 9 cholera treatment centres and 280 primary health care centres in drought-affected districts. As a result of these interventions, WHO will provide critical health services to millions of people in need, including in remote and hard-to-reach areas.
The WHO Representative to Somalia Dr Mamunur Rahman Malik, in his welcome address mentioned that, “WHO has been struggling to keep pace with the acute and overwhelming demand for health care for the vulnerable populations severely impacted by the ongoing drought”. He continued, “thanks to this very timely and much-needed support from the Government of Japan, WHO will be able to sustain its critical and life-saving health interventions in the affected areas. I also take this opportunity to urge all donors and partners working in Somalia to support scaling up our humanitarian efforts to keep the health impacts of the drought to a bare minimum that is acceptable to us”.
This support from the Government of Japan will thus be instrumental in helping to improve the lives and well-being of Somalis, as it will contribute to reducing preventable mortality and morbidity, as well as advance UHC through enhanced service delivery. With this support, WHO Somalia will continue to save lives and improve the health outcomes of people in need. WHO takes this opportunity to express its appreciation to the Government and people of Japan for this critical contribution.
Women and children under 5 are experiencing the worst impact of an unprecedented drought in Somalia. Credit: WHO/Somalia
For additional information, please contact:
Kyle DeFreitas
WHO Somalia External Relations Lead
Fouzia Bano
WHO Somalia Communications Officer
Chief of Staff ai
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Japan supports WHO to expand access to health for all in drought affected communities in Somalia
WHO supports nationwide integrated immunization campaign in the midst of drought
“God has listened to our prayers” claims a Jamame elder as WHO sets up first health camp in a decade
Demand for health services continues to grow in previously inaccessible Jamame district as WHO sets-up first temporary health camp in a decade. Credit: WHO/Somalia
Kismayo, 12 February 2023 – “God has listened to our prayers and for the first time in 10 years we are seeing public health professionals supported by the World Health Organization (WHO) providing life-saving health services to our elderly, women and especially children suffering from multiple health problems,” said one of the village elders Hassan Sheikh Yusuf hailing from Warooky village of Jamame district in Jubaland state.
Jamame is an agrarian district situated 60 kilometres northeast of Kismayo. Locations west of Juba river in Jamame district are part of the newly liberated areas in Somalia where the population has not seen any regular medical help in years. The authorities recently reclaimed part of this district from non-state actors and requested the international organizations to extend humanitarian services to the population on an urgent basis. Working under an Integrated Response Framework (IRF), endorsed by the humanitarian country team in October 2022, WHO, UNICEF and the World Food Programme immediately started joint health, water, sanitation, and hygiene (WASH) and nutrition support in parts of Jamame district, primarily focusing on Baarka, Warkooy and Sanguuni towns and its nearby villages.
Residents of Jamame district confirmed that the medical teams supported by WHO are the first one to arrive in their district in more than a decade. “Provision of health services in these God-forsaken areas is critical and as soon as we could manage to get access to the area, we sat down with the elders, established our mobile camps and started providing life-saving consultative and referral health services to the locals. We believe that every single life saved is like saving the whole of humanity and we literally did that in the shortest span of a few months,” said Abdullahi Hussein, WHO Public Health Officer for Jubaland.
Soon after deployment of WHO-supported teams revealed that the district had no immunization coverage, no tuberculosis (TB) or maternal, newborn, child and adolescent programme and communities were living without any public health services. Drought seems to further complicate the situation for the locals as an estimated 70% of inhabitants of Jamame district are affected by drought following 4 consecutive seasons of below average rainfall.
WHO, in collaboration with the State Ministry of Health, deployed 3 mobile medical teams consisting of 5 medical professionals each in Warkooy, Baarka and Sanguuni villages. Initially the teams were deployed for 4 days a week for 6 weeks but owing to the severity of the situation and demand from the locals, WHO had to extend the mission for another 6 weeks and is likely to continue this because more nearby villages have started reaching out to Jamame for consultations and various available health services.
“The main goal was to assess and ensure the provision of medical services to the affected communities in these previously inaccessible areas. Circumstances were not ideal and residents, including women and children, were suffering from multiple diseases, including diarrhoea and measles, intestinal worms, pneumonia, and bronchitis. Our teams had to set up a temporary camp inside the district to immediately start outpatient consultations, vaccination of children and provision of various supplements to children and women. We also had to send our teams to run a door-to-door campaignto raise awareness on preventive measures against epidemic-prone diseases and for adopting a healthy lifestyle besides establishing their linkage with nearby health facilities,” said Munira Aden Saleh, one of the first medical professionals providing life-saving treatment to locals.
Since the deployment of the WHO-supported teams in the first week of October, medical teams have provided medical consultation to 3861 residents of Jamame, including 1955 children under 5. More than 8917 children were screened for malnutrition, of whom 1865 were diagnosed as severely malnourished and 826 were referred to an outpatient therapeutic feeding programme and stabilization centrers in Kismayo General Hospital. Another 2592 cases with diarrhoea were treated with oral rehydration salts, 4281 received supplements like vitamin A and deworming tablets while 5706 children were vaccinated against various childhood diseases, including polio.
WHO-supported outreach vaccinator administers vaccine to one of 5706 children in Jamame district. Credit: WHO/Somalia
Initial consultations with locals also resulted in referring patients with suspected pneumonia, severe cold, worms and infection, skin infection and scabies to Kismayo general hospital for further case management, including oxygen therapy. “We are trying to connect these recently accessible populations to nearby established health facilities to not only provide them much needed medical treatments but also to help restore their confidence in public health facilities and make them part of various health interventions initiated from these health facilities,” said the Director of Kismayo General Hospital Arab Ibrahim Yasin.
For additional information, please contact:
Kyle DeFreitas
External Relations Officer
Fouzia Bano
Communications Officer
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