Somalia is experiencing concurrent cholera, measles, and diphtheria outbreaks driven by climate change, conflict, displacement, malnutrition, inadequate water and sanitation, and fragile health systems. This letter argues that these overlapping epidemics should be recognized as a syndemic rather than independent outbreaks because they share common structural determinants that amplify transmission and mortality. We advocate for integrated surveillance, combined vaccination strategies, strengthened laboratory capacity, nutrition support, climate-informed early warning systems, resilient primary healthcare, and sustained financing to improve outbreak preparedness and response in Somalia and similar fragile settings.
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Osman et al. (2026) studied this question.
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