Peer-reviewed article
Climate-informed surveillance for climate-sensitive infectious diseases in Somalia: early warning systems, policy gaps, and preparedness priorities
Abdikadir Ahmed Hassan, Liibaan Abdulahi Sudi, Mohamed Daud Mohamed, Iqro Omar Ibrahim, Yakub Burhan Abdullahi ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5This review looks at how climate change, such as droughts and floods, is increasing the risk of diseases like cholera, malaria, and measles in Somalia. It examines the country's existing warning systems for these diseases and finds that while data exists, it is not well used to trigger early action. The authors propose a new framework to connect early warning signals to actual preparedness steps at the district level. They highlight that vulnerable groups, including unvaccinated children and malnourished populations, are most at risk and need targeted outreach.
Key points
- Somalia faces both directly climate-sensitive diseases (cholera, malaria, dengue, Rift Valley fever) and indirectly climate-amplified vaccine-preventable diseases (measles, diphtheria, polio)
- Existing surveillance assets include EWARN, IDSRS/DHIS2, FEWS NET, FSNAU intelligence, WASH monitoring, and livestock signals
- These data streams are not well integrated into district-level risk assessment or pre-financed preparedness action
- The main challenge is converting warning signals into timely, disease-specific, and accountable responses, not a lack of data
- Equity-centred outreach is needed for internally displaced persons, pastoralist communities, zero-dose children, and malnourished populations
Limitations
This is a narrative review proposing a conceptual framework, not an evaluation of an implemented intervention, so it does not provide measured outcomes or effectiveness data.
Abstract
Climate variability is reshaping infectious disease risk through ecological, environmental, social, and health-system pathways. However, its operational implications remain insufficiently defined in fragile and conflict-affected settings. Somalia is a critical case because recurrent droughts and floods intersect with displacement, food insecurity, weak water and sanitation infrastructure, disrupted immunisation, livestock dependence, and constrained health-system capacity. This narrative review synthesises evidence on climate-sensitive infectious disease risks in Somalia, examines existing surveillance and early warning systems, identifies policy and implementation gaps, and proposes priorities for a climate-informed surveillance-to-action model for infectious disease control. The review distinguishes directly climate-sensitive infections, including cholera, malaria, dengue, and Rift Valley fever, from indirectly climate-amplified vaccine-preventable diseases, including measles, diphtheria, and polio. While Somalia has important surveillance and early warning assets, including EWARN, IDSRS/DHIS2, FEWS NET, FSNAU intelligence, WASH monitoring, livestock signals, and community-based reporting, these streams remain insufficiently integrated into district-level risk assessment and pre-financed preparedness action. Therefore, the central challenge is not the absence of warning signals but the failure to convert them into timely, disease-specific, and accountable responses. We propose a surveillance-to-action framework based on multisource signal detection, integrated district risk assessment, disease-specific trigger decisions, early preparedness actions, and feedback, accountability, and learning. Closing Somalia's warning-to-action gap requires pre-agreed disease-specific triggers, One Health coordination, flexible anticipatory financing, strengthened district surveillance capacity, and equity-centred outreach to internally displaced persons, pastoralist and nomadic communities, zero-dose children, malnourished populations, and hard-to-reach areas. Climate-informed surveillance should be understood not merely as better data collection but as an anticipatory public health function designed to act before climate shocks become infectious disease emergencies.