Strengthening Clinical Epidemiology in Somalia: Challenges, Opportunities, and Future Directions

Clinical epidemiology constitutes a foundational pillar of evidence-based medicine and health system strengthening. This commentary examines the current state of clinical epidemiology in Somalia and is intended to stimulate scholarly dialogue and policy action among Somali and international health stakeholders, situating the discussion within the country's broader trajectory of health system recovery and evidence-based decision-making. Despite Somalia's substantial disease burden, clinical epidemiology remains critically underdeveloped, constrained by structural, infrastructural, academic, and governance-related challenges that we delineate in detail. Simultaneously, we identify emerging opportunities - including growing international partnerships, digital health innovations, diaspora engagement, and nascent academic infrastructure - that may catalyse progress toward locally generated research capacity. We argue that deliberate investment in epidemiological capacity, curriculum reform in health sciences education, strengthened national health information systems, and clearer research governance mechanisms are prerequisites for building a robust clinical epidemiology enterprise in Somalia, and we propose priority actions spanning postgraduate training programmes, health information system investment, and the development of a nationally owned research agenda.