The National Tuberculosis Programme (NTP) in Somalia was re-established in 2004 under the Ministry of Health following years of health system disruption due to civil conflict. The Programme is responsible for coordinating national efforts for tuberculosis prevention, care, and control across the country. Implementation is carried out in close collaboration with international and local partners, including the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), the World Health Organization (WHO), and a network of international and national non-governmental organizations (NGOs). The Global Fund remains the primary financier of TB control activities, with World Vision International Somalia acting as the Principal Recipient, while WHO provides technical guidance. The NTP operates under the Ministry of Health structures across the three administrative zones—Somaliland, Puntland, and South-Central Somalia—and coordinates TB interventions through partnerships with implementing agencies. Government roles focus on stewardship, coordination, and provision of infrastructure and human resources, while service delivery is largely supported by NGO partners.

At the service delivery level, TB control in Somalia is progressively being integrated into the primary health care (PHC) system, aligned with the Essential Package of Health Services (EPHS). The EPHS framework delivers services through four tiers: primary health units, health centres, referral health centres, and hospitals, with additional expansion to community-level services through community health workers. Tuberculosis is included among the core communicable disease control programmes within this system. The country’s TB programme is implemented through a network of Directly Observed Treatment Short-course (DOTS) centres, which form the backbone of TB diagnosis and treatment. As of 2014–2015, approximately 69 functional TB centres were operating nationwide, providing about 58% population coverage, indicating significant gaps in access—particularly in rural and nomadic populations.

Despite these challenges, Somalia has made progress in TB control. Treatment success rates for smear-positive TB cases have consistently remained above 85%, reaching approximately 88% for the 2013 cohort, largely attributed to adherence to DOTS strategy and community support mechanisms.

However, tuberculosis remains a major public health concern in Somalia. The estimated TB incidence is 285 cases per 100,000 population, with a prevalence of 532 per 100,000 population, among the highest globally. Case detection remains low, with only about 43% of estimated incident cases identified annually, leaving a substantial number of undiagnosed and untreated cases contributing to continued transmission.

The burden of TB disproportionately affects the young and economically productive population (15–34 years), accounting for more than half of reported cases. Additionally, multidrug-resistant TB (MDR-TB) poses a growing threat, with an estimated prevalence of 5.6% among new cases and over 40% among retreatment cases, requiring strengthened diagnostic and treatment capacity.

The Government of Somalia, through the NTP, is prioritizing integration of TB services into primary health care, expansion of diagnostic and treatment centres, strengthening community-based TB care, and improving case detection. Strategic focus areas also include enhancing TB/HIV collaboration, scaling up MDR-TB management, improving access for underserved populations (including nomadic groups and internally displaced persons), and leveraging community health systems for early detection and adherence support.

Overall, while progress has been achieved in treatment outcomes and programme coordination, tuberculosis continues to be a leading cause of morbidity and mortality in Somalia, necessitating intensified efforts, sustained investment, and strengthened health system integration to achieve national and global TB control targets.