Real-time analytical insights for disease surveillance and response during the severe drought and food security crisis, Somalia 2022-2023.

backgroundDecades of conflict, epidemics, and climatic shocks have severely weakened Somalia's health system. The failure of five consecutive rainy seasons in 2022-2023 led to the longest and most severe drought in recent history, resulting in an unprecedented nutrition and food security crisis. These conditions have heightened the risk of disease epidemics, particularly cholera and measles. To assess the effect of interventions on disease transmission in real time, make short-term projections of disease incidence, and inform response efforts, the World Health Organization Somalia Country Office developed the Somalia infectious disease explorer (WHO-SIDE).

objectiveTo describe the development and application of WHO-SIDE and demonstrate its potential to identify high-risk areas for targeted public health interventions. DESCRIPTION: WHO-SIDE is an interactive web-based application designed using the Shiny framework in R. It estimates the time-varying reproduction number (Rt), projects case incidence, and evaluates the impact of interventions on transmission. The application uses routine disease surveillance data, offering features such as data visualization, geographic analysis, and customizable epidemic projections. IMPLEMENTATION: Since its deployment, WHO-SIDE has been used to monitor infectious disease trends, guide targeted interventions, and evaluate public health response efforts in Somalia. Outputs were reviewed jointly by WHO and Ministry of Health staff and formed part of the evidence base used to prioritise response activities. Challenges including limited access to technology, incomplete surveillance data, and a lack of trained personnel have hindered its full potential. IMPLICATIONS: WHO-SIDE highlights the feasibility and utility of analytical tools for disease monitoring and response in resource-limited, crisis-affected settings. Realising this potential will require sustained investment in three areas: building analytical capacity among local health staff; improving the completeness and timeliness of surveillance data; and developing processes for integrating modelled outputs with field intelligence. Without progress in these areas, tools such as WHO-SIDE risk producing outputs that are difficult to interpret and act upon in operational contexts.