{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T09:00:28Z","timestamp":1789894828671,"version":"4.0.1"},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:00:00Z","timestamp":1789862400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:00:00Z","timestamp":1789862400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Trop Med Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Somalia\u2019s fragile health system is increasingly threatened by reductions in humanitarian financing, with potentially serious consequences for outbreak prevention and public-health preparedness. Recent funding cuts have already resulted in the closure of health and nutrition facilities and substantial reductions in service coverage, with further closures projected under severe funding scenarios. These disruptions extend beyond reduced access to curative care; they may interrupt routine immunization, nutrition screening and treatment, disease surveillance, referral pathways, and early outbreak detection. This is particularly concerning in Somalia, where recurrent measles, cholera, and diphtheria outbreaks occur amid persistent immunization gaps, displacement, conflict, and malnutrition. The 2025 diphtheria resurgence, alongside a substantial population of zero-dose children, demonstrates the risks associated with weak prevention systems. At the same time, the high burden of acute malnutrition increases vulnerability to infectious disease and places additional pressure on already constrained health services. Protecting health facilities should therefore be considered a core outbreak-prevention priority. Sustained financing for primary health care, routine immunization, nutrition, surveillance, and emergency preparedness is essential, particularly in underserved and high-risk communities. Strengthening domestic financing and contingency mechanisms will also be critical to maintaining essential services during future funding shocks and preventing avoidable deterioration in Somalia\u2019s public-health resilience.<\/jats:p>","DOI":"10.1186\/s41182-026-01082-7","type":"journal-article","created":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T08:06:02Z","timestamp":1789891562000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["When health facilities close, outbreaks follow: the public health consequences of aid cuts in Somalia"],"prefix":"10.1186","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8170-263X","authenticated-orcid":false,"given":"Zakaria Abdi","family":"Abdullahi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6759-1829","authenticated-orcid":false,"given":"Ismail Mohamud","family":"Derow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0220-4014","authenticated-orcid":false,"given":"Mohamed Sharif","family":"Abdi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Safia shukri","family":"Hilowle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,20]]},"reference":[{"key":"1082_CR1","volume-title":"Hundreds of health and nutrition facilities closed as Somalia\u2019s child crisis deepens","author":"UNICEF","year":"2026","unstructured":"UNICEF. Hundreds of health and nutrition facilities closed as Somalia\u2019s child crisis deepens. Mogadishu\/Nairobi: UNICEF; 2026."},{"key":"1082_CR2","volume-title":"Somalia: WHO health emergency appeal 2026","author":"World Health Organization","year":"2026","unstructured":"World Health Organization. Somalia: WHO health emergency appeal 2026. Geneva: WHO; 2026."},{"key":"1082_CR3","doi-asserted-by":"publisher","DOI":"10.1186\/s41182-025-00843-0","volume":"53","author":"SA Hussein","year":"2025","unstructured":"Hussein SA, Osman MM, Hassan MM, et al. Diphtheria outbreak in Somalia: a weekly sitrep on the recent health crisis-2025. Trop Med Health. 2025;53:167. https:\/\/doi.org\/10.1186\/s41182-025-00843-0.","journal-title":"Trop Med Health"},{"issue":"1","key":"1082_CR4","doi-asserted-by":"publisher","DOI":"10.1007\/s44197-025-00395-w","volume":"15","author":"S Halane","year":"2025","unstructured":"Halane S, Ahmed A, Ahmed MM, Hersi MD, Sani J. Assessing prevalence and regional disparities in zero-dose immunization among children aged 12\u201323 months in Somalia. J Epidemiol Glob Health. 2025;15(1):59. https:\/\/doi.org\/10.1007\/s44197-025-00395-w.","journal-title":"J Epidemiol Glob Health"},{"key":"1082_CR5","volume-title":"The Republic of Korea provides US$27 million to expand lifesaving immunization for children in Somalia","author":"UNICEF Somalia","year":"2026","unstructured":"UNICEF Somalia. The Republic of Korea provides US$27 million to expand lifesaving immunization for children in Somalia. Mogadishu: UNICEF; 2026."},{"key":"1082_CR6","volume-title":"Somalia: acute malnutrition projection update for April\u2013June 2026","author":"Integrated Food Security Phase Classification","year":"2026","unstructured":"Integrated Food Security Phase Classification. Somalia: acute malnutrition projection update for April\u2013June 2026. Rome: IPC; 2026."},{"key":"1082_CR7","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S563822","volume":"19","author":"AS Siad","year":"2026","unstructured":"Siad AS, Yusuf AM, Warsame MO, Nor MA, Abshir SN, Mohammed AI. Diphtheria outbreak in Somalia: an alarming public health crisis, challenges, and solutions. Infect Drug Resist. 2026;19:563822. https:\/\/doi.org\/10.2147\/IDR.S563822.","journal-title":"Infect Drug Resist"}],"container-title":["Tropical Medicine and Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s41182-026-01082-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s41182-026-01082-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s41182-026-01082-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T08:06:09Z","timestamp":1789891569000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s41182-026-01082-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,20]]},"references-count":7,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["1082"],"URL":"https:\/\/doi.org\/10.1186\/s41182-026-01082-7","relation":{},"ISSN":["1349-4147"],"issn-type":[{"value":"1349-4147","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,20]]},"assertion":[{"value":"3 September 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This article is a Letter to the Editor based on published literature and did not involve human participants, animal subjects, or identifiable personal data. Therefore, ethical approval and informed consent were not required.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"205"}}