Abdiweli Mohamed Abdi, Mohamed Ismael Iman, Nor Haji Osman, Osman Mohamed Mohamud, Abdirahman Mohamed Jimale, Abdifatah Nour Rage, Mahad Ali Mohamud
Somalia faces recurrent infectious-disease threats shaped by interacting human, animal, environmental, and health-system vulnerabilities, including climate shocks, displacement, livestock-dependent livelihoods, weak water, sanitation and hygiene (WASH) conditions, zoonotic risks, antimicrobial resistance, and uneven surveillance and laboratory capacity. This policy-oriented narrative commentary examines these interconnected risks through a One Health and health-system risk-management lens and proposes a region-sensitive framework for prevention, preparedness, surveillance, and response. Its central argument is that recurrent outbreaks should not be viewed solely as isolated disease-specific emergencies, but as manifestations of interconnected risks that require coordinated One Health action. The commentary draws on a targeted, non-systematic synthesis of recent Somalia-specific peer-reviewed studies, surveillance updates, humanitarian reports, and institutional policy documents, supplemented by broader One Health guidance where relevant. Recent evidence includes more than 8,900 acute watery diarrhea/cholera cases by the end of 2025, 3,655 diphtheria cases across 65 districts in 2025, and 1,665 suspected measles cases during the first four weeks of 2026. The proposed conceptual framework links human health, animal health and zoonoses, and environmental and climate risks with six core system functions: multisectoral governance; integrated surveillance and data sharing; laboratory and veterinary systems; workforce capacity and community engagement; climate- and WASH-informed preparedness; and sustainable financing. Somalia has already established important One Health foundations, including multisectoral coordination, zoonotic disease prioritization, human disease surveillance, and an International Health Regulations-Performance of Veterinary Services (IHR-PVS) roadmap. The central policy proposition is to build on these foundations through a region-sensitive, government-led One Health system linking federal, state, district, and community levels. Embedding measurable One Health functions within existing preparedness and response structures may support more anticipatory, geographically responsive, and coordinated risk management while preserving essential disease-specific programs.