The Economic and Public Health Burden of Foodborne Illness in Somalia: Prevalence, Costs, and Policy Imperatives.

Foodborne illnesses exert a substantial toll on public health and economic systems globally, with low- and middle-income countries (LMICs) like Somalia being disproportionately affected due to fragile health infrastructure, limited regulatory oversight, and high prevalence of informal food markets. This study assessed the prevalence and economic burden of foodborne diseases in Somalia by integrating regional epidemiological data and cost estimates to compensate for national data gaps. Cholera remains the most frequently reported illness, but evidence from sub-Saharan Africa suggests a broader burden of pathogens such as , , and , whose surveillance remains underdeveloped in Somalia. Direct healthcare costs are substantial, ranging from outpatient care to the treatment of severe complications, such as Guillain-Barré syndrome and hemolytic uremic syndrome. Indirect costs include lost productivity, educational disruption, long-term disability, and exacerbated poverty cycles. The impact on the livestock-driven economy is also profound, with repeated export rejections and trade losses highlighting the vulnerability of Somalia's food system. This perspective underscores the urgent need for enhanced surveillance systems, regulatory harmonization, and investment in food safety infrastructure to reduce the disease burden and protect economic stability.