{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T09:19:26Z","timestamp":1789118366814,"version":"build-2803163510"},"reference-count":56,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Epidemiol."],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3389\/fepid.2026.1907542","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T08:53:00Z","timestamp":1789116780000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Climate-informed surveillance for climate-sensitive infectious diseases in Somalia: early warning systems, policy gaps, and preparedness priorities"],"prefix":"10.3389","volume":"6","author":[{"given":"Abdikadir Ahmed","family":"Hassan","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences and Tropical Medicine, Somali National University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liibaan Abdulahi","family":"Sudi","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Tropical Medicine, Somali National University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Daud","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Tropical Medicine, Somali National University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iqro Omar","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Tropical Medicine, Somali National University","place":["Mogadishu, Somalia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yakub Burhan","family":"Abdullahi","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Salaam University","place":["Mogadishu, Somalia"]},{"name":"Center for Health Research and Innovation, Somali National 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