A Nation That Chooses Prevention

Ebola does not need a hospital to spread. It needs a traveler, a crossing, and a gap in screening. That simple fact explains why a country’s readiness is decided first at its borders and only later in its clinics. Somalia has never faced a large Ebola outbreak, and that record is an advantage the nation should protect with deliberate action rather than assume will last.  Ebola can cross any borders before a hospital sees the first case. An infected traveler, a missed warning, a delayed response, that is why every point of entry matters. The question facing the country’s leaders is not whether a dangerous pathogen could someday arrive, but whether the gateways through which it would travel are ready.

Somalia operates 48 points of entry: six international airports, twelve domestic airports, twenty-two land crossings, and eight seaports. Each one is a point where national sovereignty, public safety, and commerce meet. Under the International Health Regulations (2005), a binding framework shared by 196 countries, Somalia has committed to detect, assess, report, and respond to health threats at these gateways. Meeting that commitment is not only a technical duty. It is a statement of national ambition and a demonstration that a country rebuilding after hardship can lead to security of every kind, including health.

Somalia’s National Health Security Agenda should be a federal, whole-of-government priority, grounded in the Constitution’s guarantee of the right to healthcare (Article 26 (2)) and its provisions on cooperation between levels of government (Articles 64 and 65). Federal Executive leadership should provide strategic direction, supported by clear technical coordination across federal ministries, Federal Member States, and local authorities. This approach advances Somalia’s obligations under the International Health Regulations (2005) to detect, assess, report, and respond to public-health threats, including at points of entry. Health, security, transport, and immigration authorities should share information, align their response activities, and draw on Somali expertise to identify threats early and protect communities.

What the Nation Has Already Built

The Government of Somalia, in collaboration with national and international partners, has established important foundations for a more resilient, nationally owned health security system. The Integrated Disease Surveillance and Response (IDSR) system, introduced in 2020, has strengthened the detection and monitoring of unusual health events, while national reporting as across all states in the federal system timeliness and completeness through DHIS2 reportedly increased from 62% in 2016 to 98% in 2026. These gains reflect meaningful progress in institutional capacity, health information management, and public health coordination.

Somalia’s National Transformation Plan (NTP) 2025–2029 provides a national strategic roadmap for health development under Pillar 3: Social and Human Capital, Chapter 15. It identifies Health System Strengthening as a key result area, supported by Enabler 5: Strengthening National Emergency and Prevention Preparedness and Resilience. Together, these priorities establish a national framework for strengthening public health capacity, building resilient institutions, and advancing a more sustainable health system over the next five years.

A major milestone was achieved on 18 August 2026 with the official launch of Somalia’s Pandemic Fund project, designed to strengthen pandemic prevention, preparedness, detection, and response through a One Health approach. The initiative brings together a US$24.98 million Pandemic Fund grant, US$99.6 million in partner co-financing, and US$18.4 million in government co-investment, supporting surveillance, laboratory systems, workforce development, and early-warning capacity. The National Institute of Health serves as the project secretariat, reinforcing national coordination and institutional ownership.

Somalia has already established practical arrangements to strengthen its readiness for Ebola and other public-health threats. In Mogadishu, Forlanini Hospital, also known as Lanseretti Hospital, serves as a designated public facility for isolation and quarantine, supported by emergency-care services and referral arrangements. The country’s 995 call center gives the public a direct channel to ask about outbreaks, report suspected cases and receive guidance. Together, the hospital and call centre can help connect early community reports with timely assessment and response.

Equally important is Somalia’s investment in human capital. Approximately 150 Field Epidemiology Training Program (FETP) graduates represent a growing national asset, strengthening the capacity of federal and Federal Member State institutions to investigate outbreaks, interpret surveillance data, and lead frontline public health responses. Like frontline defenders, these trained professionals are essential to detecting threats early and protecting communities. Their expertise provides a foundation for a more coordinated, skilled, and responsive national public health workforce.

The Public Health Laboratory Department of the National Institute of Health (NIH) Somalia serves as the country’s national reference laboratory Capability to confirm the cases . Somali laboratory professionals provide reliable, quality-assured testing to support disease surveillance, outbreak detection, diagnosis, and emergency response, with biosafety standards helping protect staff and communities. Experience gained during previous outbreaks, including COVID-19, strengthened Somalia’s diagnostic capacity: by 30 April 2020, three molecular testing facilities were operational after samples had initially been sent abroad. Building on this foundation, the national laboratory system supports the testing and reporting needed to turn information from across the country into timely evidence for public-health action.

The Somalia National Institute of Health (NIH) plays a central role in strengthening the national public health laboratory system and connecting laboratory services across federal and state levels. Through its leadership in public health research, disease surveillance, laboratory coordination, and emergency preparedness, the NIH supports the development of a more integrated national laboratory network capable of detecting, confirming, and monitoring public health threats. Working with Federal Member States and public health laboratories, the Institute promotes stronger diagnostic capacity, timely reporting, quality assurance, and coordinated referral systems. These efforts provide an essential foundation for evidence-based decision-making, early outbreak detection, and effective public health response across Somalia.

Health security is also increasingly recognized as a whole-of-government responsibility. A cabinet-level committee chaired by Second Deputy Prime Minister Jibriil Xaaji Cabdi, bringing together the ministries responsible for health, security, foreign affairs, transport, information, and livestock, provides an important mechanism for strengthening intersectoral coordination. Together with surveillance systems, emergency preparedness arrangements, digital reporting tools, and international partnerships, these developments demonstrate that Somalia is building on existing capabilities rather than starting from zero. The priority now is to consolidate these achievements through sustained domestic investment, effective implementation, and coordinated action across all levels of government.

An Honest Look at the Work Ahead

Somalia continues to strengthen its health security system amid a complex operating environment shaped by prolonged conflict, climate-related emergencies, geopolitical uncertainties, and fluctuations in international financing. These challenges underscore the importance of sustaining public health programmes, strengthening laboratory services and workforce capacity, and maintaining emergency preparedness. Sustained government leadership, stronger federal–state coordination, and investment in the National Institute of Health, public health laboratories, and points of entry remain essential to building a resilient, self-reliant health system.

A credible national plan begins with an evidence-based assessment of existing capacities and clear priorities for improvement. Somalia’s points of entry identified opportunities to strengthen health screening, medical staffing, and preparedness across seaports, land borders, and domestic and international airports. These findings underscore the importance of establishing consistent screening protocols, deploying trained health personnel, and improving emergency referral systems at strategic entry points.

At the national level, strengthening health security requires sustained investment in surveillance, laboratory systems, risk communication, cross-border collaboration, and the health workforce. Greater domestic resource mobilization, alongside predictable international support, is essential to building resilient public health institutions. Effective coordination between federal and state authorities, supported by improved access to vulnerable and insecure border areas, will further enhance preparedness and response.

Regional cooperation is equally important. Somalia’s shared borders with Kenya and Ethiopia and those close business create interconnected public health risks that require coordinated surveillance, timely information exchange, and joint emergency preparedness. Strengthening Somalia’s points of entry and national health security capacity is therefore not only a national development priority but also a strategic investment in the health security of the wider Horn of Africa.

A National Agenda

The first priority is to screen where risk is highest. International airports, seaports, and the busiest land crossings should have trained staff deployed, designated isolation areas, and clear referral pathways to treatment centers. Screening should follow WHO guidance, treat every traveler with dignity, and avoid unnecessary restrictions on travel and trade. Alongside screening, the Government should place a trained health officer at every major point of entry, beginning with the domestic airports that have limited advanced diagnostic and medical staff today, and draw on graduates of the Field Epidemiology Training Program to fill these posts.

The second priority is speed and unity. A suspected case must be confirmed in days, not weeks, which requires decentralized diagnostics, reliable sample transport, and close partnership with Africa CDC and regional reference laboratories. At the same time, federal and regional authorities should operate from common protocols, the Public Health Emergency Operations Centre should be completed, and every crossing should have a designated focal point connected to the national IHR focal point.

The third priority is partnership and sustainability. Somalia should formalize real-time data sharing and joint border drills with Kenya, Ethiopia, Djibouti, and Africa CDC, because a pathogen does not respect a boundary and neither can preparedness. At home, the Government should create a protected budget line for border health and set a path toward the Abuja target, while inviting partners to make multi-year zcommitments in place of short-term emergency funding. November 2025 review’s regional benchmark of moving at least half of points-of-entry health investment to domestic and private co-financing offers a sensible direction.

Earning the Public’s Trust

Trust is a public health asset. The Government should speak to citizens clearly and calmly in Somali and in local languages, using radio, social media, religious and community leaders, and the diaspora. When families understand the symptoms of the disease, the importance of safe burial practices, and where to report illness, they become the strongest early warning system a nation can have. Regular simulation exercises at airports and border crossings, reported publicly, will show citizens and partners that the system works and that the Government is accountable for results.

How Success Will Be Measured

The Government can set and report on measurable outcomes. Screening should be operating at all international airports and seaports and at priority land crossings, with a trained officer at every major point of entry. The Public Health Emergency Operations Centre should be functioning under a single national protocol for suspected cases, and laboratory confirmation within days should be proven in at least one national simulation exercise. A dedicated border health budget line and a signed regional data-sharing arrangement should be in place, and the self-assessed capacity score reported to the World Health Organization should show a measurable rise. Reporting these results openly, quarter by quarter, will strengthen the Government’s credibility at home and abroad.

A Defining Choice

Somalia stands at a moment of opportunity. It has institutions, partnerships, and growing public investment on which to build, and the weaknesses at its borders are known, specific, and fixable. A Ministerial Committee led by the Office of the Prime Minister would give the country what it needs most: one command, one plan, and ownership (National Transformation Plan) at the highest political level.

Prevention is the wisest investment a government can make. It costs far less than a crisis, and it protects lives, trade, and national confidence. By acting now, Somalia can show the region that a nation rebuilding after hardship can also lead on health security, and that its gateways can be made strong before any threat arrives.

Author Bio

Dr. Saadaq Adan Hussein, MBChB, MSc TID, PGD Law, FETP graduate.

Health Policy Specialist, Office of the Prime Minister, Federal Government of Somalia.

Postgraduate Mentorship Coordinator, School of Postgraduate and Research Studies, Benadir University.

CEO and Founder and Research and Policy Development SOR Institute: Somali Social Research.

Focus: Infectious Diseases, One Health, Epidemiology, Health Politics and Policy, Health Security, Medical Law, Criminology.