The world must not wait for a famine declaration in Somalia before acting

Half of young children screened by MSF in Baidoa, Somalia are acutely malnourished.

A Mother feeds her severely malnourished son

Amid drought and severe aid cuts by the United States and other donors, half of the young children screened in displacement sites in Baidoa, Somalia, are acutely malnourished, and one in every four is severely malnourished. These shocking statistics are the findings of a malnutrition survey carried out in July by Médecins Sans Frontières/Doctors Without Borders (MSF).

In response, MSF has increased the bed capacity at Bay Regional Hospital in Baidoa, and distributed relief items and water to displaced families, but we cannot do it alone. MSF is urgently calling on the donor community, international organisations, and health authorities to ensure a well-coordinated, adequately funded, and effective emergency response without delay in Baidoa and other affected areas of Somalia.

A nurse measures a child's mid-upper arm circumference
A nurse measures a child's mid-upper arm circumference (MUAC) at MSF-supported health post in Bur-shabelow internally displaced persons (IDP) site in Baidoa, Somalia. © Yahya Mohammed/MSF

We are witnessing a shocking lack of urgency to a critical emergency

“Behind every statistic is a child,” said Allara Ali, MSF's project coordinator in Somalia. “What we are seeing is shocking and far beyond the threshold of an extremely critical emergency. What is equally shocking is the lack of urgency from donors who continue to downscale and withdraw support from Somalia. While other actors are attempting to respond, their capacity is limited by funding constraints."

Traditional donors, including the US, the UK, and others, have deprioritised Somalia, leaving humanitarian organisations without the resources needed to prevent avoidable deaths. The US was one of Somalia’s leading donors for years before fully halting its support in 2026.

The world cannot wait for a famine declaration before acting... Action is needed now to prevent the loss of lives.

Allara Ali / MSF project coordinator in Somalia

The MSF survey, conducted across 888 households in 14 displacement sites in Baidoa, found that one-third of families are surviving on just one meal a day, while only two per cent can afford three meals a day.

The results are consistent with MSF’s regular malnutrition surveillance in Baidoa, where teams have screened more than 21,000 children under five since the beginning of the year and found global acute malnutrition levels of around 50 per cent.

“The world cannot wait for a famine declaration before acting,” said Ali. “Action is needed now to prevent the loss of lives.”

Adegey Ali with her daughter
After two months unable to reach care, mother of five Adegey Ali brought her daughter to a hospital for the first time. Her daughter had been sick for two months before the family could reach the hospital in Baidoa, 30 kilometres from Gofgaduud, the rural area where they live. © Yahya Mohammed/MSF

What's going on in Somalia?

  • Around 6 million people in Somalia - about one-third of the population - are estimated to be facing food shortages
  • Nearly 1.9 million people are experiencing emergency levels of food insecurity, meaning they need urgent support
  • Almost 512,000 people were displaced within Somalia during the first three months of 2026
  • Somalia’s Humanitarian Needs and Response Plan was reduced to US$852 million in 2026, and only targets 2.4 million people, reaching less than half of those in need
  • International support to Somalia has fallen by 88 per cent compared to 2022.
Patients sit in the waiting area of MSF’s health post in Elbeti IDP camp
Patients sit on mats in the waiting area of MSF’s health post in Elbeti internally displaced persons (IDP) camp, Baidoa, Southwest State, Somalia. MSF runs seven health posts across IDP camps in Baidoa, providing primary healthcare including screening and treatment for acute malnutrition. © Yahya Mohammed/MSF

Drought and displacement are worsening malnutrition

Consecutive failed rains and worsening drought have affected hundreds of thousands of people across Somalia, depriving families of food, water, crops, and livestock. According to the UN, in the first three months of 2026, more than half a million people were displaced in Somalia, with nine out of 10 displacements driven by drought. Alarmingly, 85 per cent of those displaced are women and children, who are also among the most severely affected by malnutrition.

Since the beginning of the year, more than 21,000 children have been admitted to MSF-supported outpatient malnutrition facilities in Baidoa - more than double the number recorded during the same period last year. Additionally, 2,890 children have been admitted for inpatient care, an increase of 78 per cent compared with the same period in 2025. Figures in 2025 were already higher than the year before. A similar trend is being seen in Mudug, where admissions to MSF-supported inpatient facilities increased by 70 per cent in June and July.

A hospital bed can save a child today. But it cannot protect that child if they return to a shelter with no food, no clean water, and no basic services.

Allara Ali / MSF project coordinator in Somalia

“It is rare that we are able to get two meals a day. There is no organisation helping us. An organisation gave us some cash assistance, but that was three years ago,” said Nuriyo, mother of a child being treated for severe acute malnutrition in Baidoa.

Measles and diphtheria are spreading in a context where vaccination campaigns are not reaching everyone effectively. Since the beginning of the year, MSF has treated around 2,500 measles cases in Baidoa, compared with about 1,700 cases during all of 2025. Pregnant and lactating women are also severely affected. In the past two months alone, MSF has admitted more than 2,600 pregnant and breastfeeding women for malnutrition support. When mothers are malnourished, the risks extend to their babies - before birth, during delivery, and in the first months of life.

Residents fetch water at an MSF-supported water point in an IDP camp in Baidoa
Residents fetch water at an MSF-supported water point in an IDP camp in Baidoa, Somalia. MSF provides safe water at 17 points like this as part of its response to the drought and displacement crisis in the city. © Yahya Mohammed/MSF

MSF is scaling up its response, but cannot do it alone

To respond to the surge in patients, MSF has expanded one medical facility from 50 to 150 beds. MSF teams have also distributed relief items to displaced families and are trucking safe water to displaced communities in Mudug and Baidoa. But medical care and emergency assistance alone cannot meet the scale of this crisis.

“A hospital bed can save a child today,” said Ali. “But it cannot protect that child if they return to a shelter with no food, no clean water and no basic services. Without comprehensive support, including social protection, the cycle of relapse and readmission will continue.”

Nurse Hawa Hassan checks the temperature of a child
Nurse Hawa Hassan checks the temperature of a child at Farboor health post in the IDP site supported by MSF in Baidoa, Somalia. © Yahya Mohammed/MSF

Funding cuts are weakening already fragile health services

Despite the level of suffering, Somalia is being deprioritised by major donors, including the United Kingdom and the United States. Somalia’s humanitarian response plan has been reduced by 40 per cent in 2026 and was still less than one-third funded by July. Funding cuts are weakening already fragile health services and forcing the health system to absorb a crisis far beyond its capacity.

“The malnutrition and health crisis in southwestern Somalia is becoming a clear example of dangerous indifference and a failure of responsibility, as Somalia is pushed further down the global agenda,” said Ali. “The scale of this crisis should be a wake-up call for the international community.”

MSF is calling for an urgent scale-up of inpatient treatment for severe acute malnutrition, particularly for children with medical complications. This must include increased bed capacity and additional medical staff as well as uninterrupted supplies of therapeutic food, medicines, and medical equipment. We also urge urgent vaccination campaigns to reach missed and hard-to-reach communities, with stronger coverage and more effective delivery.