Laboratory capacity-building during COVID-19 in Somalia: improving access to essential diagnostics for national health security in a fragile setting

Figuereo, S; Mohamed, SI; Takele, D; Sheikh, AM; Abera, SC; Mohamed, AM; Lubogo, M; Abukar, HM; Karanja, MJ; Bangura, S; Fayad, AA; Adam, AH; Osman, AY; Malik, SMMR

Abstract

IntroductionEven before the COVID-19 pandemic, Somalia's national laboratory services had insufficient diagnostic capacities. We describe how the country moved rapidly from no testing capability to molecular testing and genomic sequencing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other pathogens.MethodsWe reviewed primary sources information as well as data and records from secondary sources from 1 January 2020 to 31 December 2023. We also analyzed laboratory surveillance data of cases of COVID-19 and other epidemic diseases reported during the same period and the number of laboratory tests performed during the same period. We used this information to demonstrate improvements in laboratory diagnostic capacity in Somalia before, during and after the COVID-19 pandemic.ResultsThe country was able to rapidly scale up testing for SARS-CoV-2 using reverse-transcriptase polymerase chain reaction assays. At the same time, other innovative solutions were used for testing, such as repurposing tuberculosis GeneXpert diagnostic platforms to increase access to testing at points-of-care and introducing antigen rapid diagnostic tests for hard-to-reach communities. Somalia also acquired new generation sequencing capability for detection and characterization of circulating SARS-CoV-2. These laboratory and testing enhancements have enabled Somalia to participate in surveillance for priority diseases and detection of outbreaks caused by emerging pathogens.ConclusionSomalia's strategic approach to COVID-19 is an inspiring example of resilience and adaptability. Utilizing resources, technology and lessons from COVID-19 enabled the country to increase and improve laboratory services, expand testing capacity, and strengthen workforce capability. As such, Somalia can now better respond to other infectious disease threats and has significantly improved national health security.

Citation

Figuereo, S., Mohamed, S., Takele, D., Sheikh, A., Abera, S., Mohamed, A., Lubogo, M., Abukar, H., Karanja, M., Bangura, S., Fayad, A., Adam, A., Osman, A., & Malik, S. (2025). Laboratory capacity-building during COVID-19 in Somalia: improving access to essential diagnostics for national health security in a fragile setting. Journal of epidemiology and global health, 15(1), https://doi.org/10.1007/s44197-025-00350-9

• Journal Article Type: Article
• Acceptance Date: Dec 21, 2024
• Online Publication Date: Feb 5, 2025
• Publication Date: 2025
• Deposit Date: Feb 21, 2025
• Publicly Available Date: Feb 21, 2025
• Electronic ISSN: 2210-6014
• Publisher: Springer Nature Link
• Peer Reviewed: Peer Reviewed
• Volume: 15
• Issue: 1
• DOI: https://doi.org/10.1007/s44197-025-00350-9
• Keywords: COVID-19; Laboratory capacity; Testing; Genome sequencing; Somalia