Mogadishu, Somalia – When the U.S. abruptly slashed foreign aid to Africa, Somalia—long dependent on external support for its fragile health system—felt the impact almost immediately. Over eight months later, cracks have widened into chasms: clinics are scaling back or shutting entirely, vaccination campaigns are faltering, and essential medicines sit unused in warehouses. The long-feared public health disaster is now unfolding.
Somalia already carried a heavy burden before the cuts. The country’s population is estimated at about 18.36 million people (2023) according to WHO data. Hunger and malnutrition loom large: currently, 4.6 million Somalis face high levels of acute food insecurity, and 1.8 million children under age five are suffering from acute malnutrition. Nutrition assessments project 1.7 million children between 6–59 months will experience acute malnutrition in 2025, including about 466,000 severe cases. Meanwhile, chronic undernutrition affects more than one in four children: 25.3 % of Somali children under five are stunted, a marker of long-term growth failure.
On the HIV front, Somalia’s prevalence has long been relatively low compared to regional peers. UNAIDS and WHO estimates place HIV prevalence in adults (aged 15–49) at under 0.1%. In 2020, about 8,700 persons (adults and children) were living with HIV in Somalia. But even in a low-prevalence setting, interruptions in services can be deadly: drug stock-outs and halted testing make loss of viral control and undetected infections more likely.
In 2025, the health damage is already visible. Diphtheria has surged: over 1,600 cases and 87 deaths have been recorded so far this year—nearly double the figures from 2024, when there were 838 cases and 56 deaths. Multiple outbreaks are active, including cholera, measles, and acute watery diarrhea, driven by collapsed vaccination efforts and deteriorating water and sanitation access. Children are especially vulnerable. One ICRC-supported nutrition center in Kismayo has admitted nearly 900 severely malnourished children this year alone, while across several clinics, thousands of displaced families are left without treatment.
These statistics underline that the U.S. aid cuts are not just political decisions—they are life-and-death shifts on the ground. In Somalia, where institutional resilience is fragile and conflict compounds every crisis, the withdrawal of funding brings the danger of spiraling epidemics, rising child mortality, and irreversible setbacks in public health.