87 deaths, over 1,600 cases: Somalia sees diphtheria surge as Trump aid cuts hamper vaccination

Diphtheria cases and deaths have risen sharply this year in Somalia, where the response has been curtailed by vaccine shortages and US aid cuts, Somali officials said.

More than 1,600 cases, including 87 deaths, have been recorded, up from 838 cases and 56 deaths in all of 2024, said Hussein Abdukar Muhidin, the general director of Somalia’s National Institute of Health.

Diphtheria, a bacterial disease that causes swollen glands, breathing problems and fever and mostly affects children, is preventable with a vaccine that became widely available in the mid-20th century.

Childhood immunisation rates in Somalia have improved over the past decade, but hundreds of thousands of children are still not fully vaccinated.

After fleeing fighting between government forces and Islamist militants in the central Somalia town of Ceeldheere three months ago, all four of Deka Mohamed Ali’s children, none of whom was vaccinated, contracted diphtheria. Her 9-year-old daughter recovered, but her 8-year-old son died and two toddlers are now being treated at a hospital in the capital Mogadishu.

“My children got sick and I just stayed at home because I did not know it was diphtheria,” she told Reuters from the bedside of her 3-year-old son Musa Abdullahi whose throat was swollen to the size of a lemon from the infection.

Health Minister Ali Haji Adam said the government had struggled to procure enough vaccines due to a global shortage and that US aid cuts were making it difficult to distribute the doses it had.

Before President Donald Trump cut most foreign assistance earlier this year, the United States was the leading humanitarian donor to Somalia, whose health budget is almost entirely funded by donors.

“The US aid cut terribly affected the health funds it used to provide to Somalia. Many health centres closed. Mobile vaccination teams that took vaccines to remote areas lost funding and now do not work,” said Adam.

Muhidin separately echoed his comments about the closures.

Overall US foreign assistance commitments to Somalia stand at $149 million for the fiscal year that ends on September 30, compared with $765 million in the previous fiscal year, according to US government statistics.

“The United States continues to provide lifesaving foreign assistance in Somalia,” a US State Department spokesperson said when asked about the impact of its aid cuts in the country.

“America is the most generous nation in the world, and we urge other nations to dramatically increase their humanitarian efforts.”

Aid group Save the Children said last month that the closure of hundreds of health clinics in Somalia this year due to foreign cuts has contributed to a doubling in the number of combined cases of diphtheria, measles, whooping cough, cholera and severe respiratory infections since mid-April.

Besides the US, Britain, France, Germany and other major Western donors are also cutting aid budgets.

Somalia’s government has also faced criticism from doctors and human rights activists for its limited funding of the health sector. In 2024, it allocated 4.8% of its budget to health, down from 8.5% the previous year, Amnesty International said.

The health ministry did not respond to a question about that criticism. It has said it is planning to launch a vaccination drive but has not given details when.