Commemorating World TB Day 2025: Reflections on Somalia’s Progress in the Fight Against TB

A Painful Journey of Misdiagnosis 

Meet Hassan*. His life has been dramatically altered by a series of misdiagnoses before finally receiving the correct treatment for extrapulmonary tuberculosis (TB). His story is one of resilience, hardship, and ultimately, hope.

It began with a desperate search for answers. When illness first struck, Hassan's family turned to a traditional healer for help. The treatment involved painful rituals, that left burn marks on his back, yet his condition worsened. Desperate for a cure, they sought help at a health facility, only to face another misdiagnosis, this time, doctors believed surgery on his hand would solve the problem. Despite the operation, his health deteriorated, deepening the family's fear and uncertainty.

Determined to save their son, his parents continued seeking medical attention, until they arrived at Garowe Hospital, where he was correctly diagnosed with extrapulmonary TB. After two months of appropriate treatment, his condition improved significantly, replacing the family’s despair with hope. But this came at a tremendous cost, the family spent US$ 2,000 in pursuit of the right care, a financial strain that pushed them to their limits. At one point, they even considered seeking treatment outside of Somalia, not sure if they would find help their son desperately needed. 

Today, thanks to accurate diagnosis and treatment, the boy is on the path to recovery. His story highlights the importance of timely medical intervention and the devastating consequences of misdiagnosis for families already facing hardship.

As we commemorate World TB Day 2025, we reflect on Somalia’s achievements, ongoing challenges, and the path forward toward eradicating TB. For it is unacceptable that anyone should suffer or die from a curable disease! It is encouraging to note that Somalia has made remarkable progress in its fight against TB. Some of these include:

• The TB mortality rate decreased from 67 per 100,000 in 2018 to 63 per 100,000 in 2023. 
• TB incidence dropped from 262 per 100,000 in 2018 to 243 per 100,000 in 2023. 

These achievements are a result of strong collaboration. World Vision has been the principal funding recipient of the Global Fund’s Tuberculosis (TB) Control programme in Somalia since 2005, partnering with the Government and other implementing partners to deliver TB control and support services across Somalia and Somaliland.

From Patient to Advocate: One patient’s experience highlights the impact of TB education. 

Generations of his family suffered from TB, leading them to believe it was hereditary. He and his brother, both artisans working in a small workshop, contracted TB. When they enrolled for treatment at Doloh TB Centre, they learned that TB is not hereditary but spreads through the air! Initially sceptical, they believed it only when a co-worker from their workshop was also diagnosed. 

After successfully completing his treatment, the patient became an Advocate, educating people at his workplace and in his village. “If I see someone coughing, I tell them: ‘Please cover your mouth, go to the TB centre, and get checked.” This transformation highlights the power of education in breaking myths and promoting early diagnosis.

TB Diagnosis made easier 

Haretho, a 47-year-old mother of four from Afgoye district in the Lower Shabelle Region of Somalia, was diagnosed with tuberculosis in 2024. Fearful of the long treatment process, she worried about managing her condition. With the support of the Global Fund TB programme and advanced technology like the GeneXpert machine, she received a quick and accurate diagnosis, allowing her to start treatment immediately. 

“The doctors were able to quickly diagnose my TB and start me on the right treatment without delay, “Haretho shared. The healthcare workers guided me every step of the way, answering my questions, addressing my concerns, and providing the medication I needed.” 

Today, Haretho is fully recovered and advocates for TB awareness in her community, urging others to seek timely medical care. 

A Future Free of TB

TB remains one of Somalia’s most pressing public health threats, yet progress is underway. Through Global Fund investments and World Vision Somalia’s leadership, significant strides are being made in detection, treatment, and prevention, despite challenges such as drought, conflict, and displacement. As of 2024, the treatment success rate has consistently remained above 90%. The number of TB Management Units (TBMUs) has more than doubled, from 52 in 2018 to 114 in 2024, and we are now working with over 700 community healthcare providers including doctors and nurses trained in TB management to strengthen service delivery and reach more people in need. 

We also work closely with a network of Community Health Workers trained on TB detection and referrals. These frontline workers are helping bring life-saving services closer to the communities that need them most.

The fight against TB is not only about treatment, but it also requires strengthening Somalia’s entire healthcare system. With Global Fund support, World Vision has also:

• Expanded TBMUs to provide maternal and child health services.
• Repurposed GeneXpert machines for COVID-19 and HIV viral load testing, maximising their impact. 
• Enhanced supply chain management to reduce stockouts and ensure continuous TB treatment.
• Launched a multisectoral engagement policy, clearly defining roles for non-health sectors in the TB response.

But challenges persist. 

TB continues to disproportionately affect Somalia’s youth and vulnerable populations: According to WHO's 1st TB Catastrophic Cost Survey Data, 68% of TB-affected households experience catastrophic costs, 57% of TB cases occur in individuals under 34 years old, 30% of TB patients are aged 15 to 24, 18% of TB cases are in children under 15 and the burden of drug-resistant TB remains high at 12 per 100,000 cases. Addressing these challenges require targeted interventions, expanded social protection, and stronger integration within the health system.

Innovation A Game Changer for TB Response

Somalia is embracing technology to accelerate TB detection and treatment:

• 90% of TB facilities now utilize GeneXpert, enhancing diagnostic speed and accuracy.
• 27 mobile X-ray units have been deployed to reach underserved communities.
• AI-powered diagnostics are improving efficiency and addressing radiologist shortages 

These advancements are transforming Somalia’s TB response but scaling them further is critical.

Expanding Access to Reach Underserved Communities must be Prioritised 

Efforts to reach underserved populations include:

• 10 to 12% of TB cases detected through active case-finding in prisons, IDP camps, and private clinics.
• Integration of TB services into primary healthcare for better accessibility.
• Strengthened public-private partnerships improving TB diagnosis and treatment.
• Significant reductions in TB medication stockouts, ensuring continuous access to treatment.

Expanding these efforts will be key to closing service gaps and protecting the most vulnerable.

Strengthening Integrated Care for TB & HIV 

Recognising the link between TB and HIV, Somalia has prioritised integrated care:

• 95% of TB patients are now aware of their HIV status.
• 81% of co-infected patients-initiated TB Preventive Therapy in 2024.

What’s Next?

To achieve the End TB Strategy targets by 2030, Somalia must:

• Scale up innovative diagnostic tools and AI-driven solutions.
• Expand social protection programmes to alleviate financial burdens on TB-affected households.
• Strengthen government leadership and multisectoral engagement.
• Sustain investment in TB prevention, treatment, and advocacy.

How You Can Get Involved

• Support the expansion of TB diagnostics and treatment programmes.
• Partner with NGOs and health agencies to strengthen TB interventions.
• Advocate for policy reforms to reduce financial barriers for TB patients.
• Invest in research and technology to improve TB detection and care.

Together, we can drive the final push toward ending TB in Somalia. Join the fight. Let’s make TB history.

Photo Disclaimer: Imagesrelated to this story are too sensitive to share. To uphold dignity and privacy, we’ve chosen alternative photos from our archives. 

Dr. Norbert Rakiro, is the Chief of Party for World Vision Somalia Global Fund TB Programme.