Addressing the 2025 diphtheria surge in Somalia: A call for urgent policy action

Somalia has reported approximately 1,600 suspected diphtheria cases and 87 deaths in 2025 to date (January–August), almost double the cumulative toll for 2024, with a case-fatality ratio consistent with delayed antitoxin access and late care-seeking (1). This rise coincides with vaccine supply constraints, reduced external financing, and service disruptions in high-mobility districts (1). Clinical control requires early diphtheria antitoxin plus antibiotics (erythromycin or penicillin) as per the WHO 2024 guidance, with ward-level droplet precautions and immediate prophylaxis for close contacts.