Health system preparedness for Ebola virus disease in Somalia a narrative review of challenges and opportunities

Abstract

Ebola virus disease (EVD) remains a significant public health threat, particularly for fragile and conflict-affected countries with limited health system capacity. Although Somalia has not experienced a confirmed EVD outbreak, its proximity to affected regions, population mobility, humanitarian crises, and persistent health system challenges increase the risk of disease importation. This narrative review synthesizes current evidence on Somalia’s preparedness for EVD, examining surveillance, laboratory capacity, infection prevention and control, workforce readiness, emergency coordination, risk communication, and community engagement within the broader context of health system strengthening. The available evidence indicates that while progress has been made in surveillance, emergency preparedness, and policy development, substantial gaps remain across critical preparedness capacities that could compromise timely detection and effective outbreak response. The review argues that EVD preparedness should be integrated into broader health system strengthening rather than implemented as a disease-specific vertical program. Strengthening core health system functions will improve resilience to Ebola and other emerging infectious disease threats while enhancing overall public health emergency preparedness.