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Somalia
Health Overview
Key Health Risks
Health Risk Callout
Other Health Risks
Regional Information
Vaccine and Malaria Prevention
- Risk Level: High
- Areas: All areas; highest in southern river basins (Jubba, Shabelle)
- Recommended Drug: Atovaquone-proguanil; doxycycline; mefloquine; tafenoquine
- Drug Resistance: Yes
P. falciparum with chloroquine resistance throughout. Do not use chloroquine. All travelers require prophylaxis.
Physician Note
I do not recommend travel here currently. Somalia is Level 4, there is no permanent US consular presence, and these notes are for authorized humanitarian personnel operating under an organizational security framework. WHO's March 2026 situation analysis describes three concurrent outbreaks — cholera, measles, and diphtheria — running against 6.5 million people in acute food insecurity. Diphtheria is the one I want on your radar: suspected cases rose roughly tenfold in 2025 to over 3,500 with a case fatality near 4%, and it lands in the middle of a global diphtheria antitoxin shortage — the same shortage driving mortality in Haiti, Niger, and Yemen. Ensure Tdap is current and understand that antitoxin will not be available in-country.
Chloroquine-resistant P. falciparum runs throughout, heaviest in the Jubba and Shabelle river basins — prophylaxis for every traveler. Polio remains on CDC's global notice for Somalia; bring the booster. There is no ambulance system — Aamin Ambulance in Mogadishu is nearly the only provider — and Madina Hospital has no CT scanner and no formal blood bank. AMREF from Nairobi is the realistic medevac plan, contracted before entry, not after injury.
Pre-Departure Checklist
8+ Weeks
- DO NOT TRAVEL HERE — Somalia is Level 4 (crime, terrorism, civil unrest, health, kidnapping, piracy). There is no permanent consular officer. Confirm whether the trip should proceed at all
- Polio booster — REQUIRED; Somalia is on the poliovirus list
- Routine vaccines including MMR
- Hepatitis A
- Hepatitis B
- Typhoid
- Cholera
- Rabies
- Meningococcal for travel to northern areas
- Malaria prophylaxis for all areas — chloroquine-resistant P. falciparum throughout; chloroquine is not appropriate, and all travelers require prophylaxis
- No yellow fever certificate required — yellow fever does not occur in Somalia
2-4 Weeks
- Confirm medical evacuation cover AND a security organization in writing — both mandatory
- Confirm evacuation routing — AMREF; the FAA SFAR applies to Somali airspace
- Water purification capability — tap water is not safe anywhere
- Carry a complete medication supply from home
Day Of
- There is no reliable emergency number and no ambulance service
- US Embassy Kenya +(254)(20) 363-6000 — emergencies route through Embassy Nairobi
- Madina Hospital, Mogadishu
- Bottled or purified water only; thoroughly cooked food only — cholera is active
- Fever with haemorrhagic features — Rift Valley fever occurs periodically
Trip Type Guidance
No trip types appropriate. Only authorized humanitarian/UN.
