Context:

Diphtheria, once largely eradicated in many parts of the world, is making a dangerous resurgence, particularly in Somalia, Sudan, Yemen, and Chad due to factors like war, climate change, and vaccine hesitancy. The disease is primarily affecting children in areas with low vaccination rates and weak healthcare systems, with Somalia reporting over 2,000 cases in 2023 alone, a dramatic increase from previous years. The decline in routine immunizations exacerbated by the COVID-19 pandemic has allowed diphtheria to spread unchecked, leading to high mortality rates among affected populations. As health systems struggle with resource limitations, countries like Somalia are now seeking new funding for vaccination initiatives. The outlook remains grim as more children face severe illness and malnutrition amidst ongoing humanitarian crises.

Dive Deeper:

• In Somalia, nearly 1,000 patients were admitted to the diphtheria ward at Demartino Hospital in 2023, a stark rise from just 49 in the previous year, with 80% of those affected being children.

• Diphtheria outbreaks have also been reported in Sudan, Yemen, and Chad, where civil unrest and refugee crises have led to low vaccination rates and inadequate healthcare infrastructure.

• Historically, diphtheria cases in the U.S. dwindled significantly after the vaccine was introduced in the 1940s, but the disease has re-emerged in various global regions, including a major outbreak in Venezuela due to political instability.

• The World Health Organization notes that in regions with limited healthcare, the fatality rate for diphtheria can be as high as one in four children, while in better-resourced areas, it is closer to one in 20.

• Somalia is seeking new funding from Gavi for diphtheria booster shots aimed at children aged 2, 4-7, and 9-15, in response to the ongoing outbreak.

• Amina Hassan, a mother whose three children were hospitalized, indicated that her husband’s refusal to vaccinate stemmed from a past adverse reaction to a tuberculosis shot, highlighting challenges in addressing vaccine hesitancy.

• The resurgence of diphtheria is compounded by malnutrition, as many children in Somalia face severe food shortages, further weakening their immune systems and making them more susceptible to infections.