Tuberculosis in Somalia: A Narrative Review of Epidemiology, Health System Challenges, and Future Directions.

Tuberculosis (TB) remains a major public health challenge in Somalia, a country affected by prolonged conflict, population displacement, and fragile health systems. Despite global progress in TB control, Somalia continues to report a high burden of disease, with substantial gaps in the detection, treatment coverage, and management of drug-resistant TB. This narrative review synthesizes the available evidence on the epidemiology of TB in Somalia, examines the health system and socio-environmental determinants of transmission, reviews the national TB control response, and highlights key challenges and future directions for TB elimination. Strengthening surveillance, expanding access to diagnostic and treatment services, integrating TB care within primary healthcare, and addressing social determinants are critical for accelerating TB control in Somalia.