London School of Hygiene & Tropical Medicine

An estimated 43,000 excess deaths occurred in Somalia in 2022 due to drought, half of which were children under five years old, according to modelling by the London School of Hygiene & Tropical Medicine (LSHTM).

These estimates are similar to those recorded during the 2017 to 2018 drought crisis and may continue to rise at alarming levels, potentially surpassing these figures this year.

This report comes in the context of the current drought in the Horn of Africa, cited as one of the worst hunger crises of the last 70 years. 

The authors emphasise the need for urgent action to improve conditions if death rates are to return to pre-crisis levels.

Regions in the Horn of Africa including southeast Ethiopia, northern Kenya and Somalia are currently experiencing a severe drought.

In Somalia, this latest crisis, which began in 2021, is one of an unprecedentedly frequent series of droughts that have affected the country since 2008. It also comes against the backdrop of ongoing food insecurity, rising global prices and the impacts of the COVID-19 pandemic.

Estimated figures of excess deaths have previously been published for both the 2010 to 2012 famine and the 2017 to 2018 drought crisis in Somalia, the latter predicted to have resulted in 45,000 excess deaths.

In this report, researchers from LSHTM aimed to expand estimates of excess deaths from 2018 up to December 2022. They also sought to forecast how death rates may change over the first six months of 2023 under scenarios where conditions either stay the same, deteriorate further or improve.

Using data from 238 mortality surveys conducted by the Food Security and Nutrition Analysis Unit for Somalia, the authors’ modelling revealed that the death rate overall and for children under five years old was higher between 2017 and 2018 and in 2022 compared to periods between recent drought crises. 

Overall, death rates increased from approximately 0.33 deaths to 0.38 deaths for every 10,000 people every day between January 2022 and the end of that year. For children under five years old, the increase was estimated to be nearly double this level.

Considering baseline figures from before 2017 (defined as the total number of expected deaths if no drought was taking place), the authors estimate that around 43,000 excess deaths occurred in Somalia in 2022, with half of these numbers being children aged under five. Regions in south-central Somalia, notably Bay, Bakool and Banadir, are estimated to have had the highest number of excess deaths.

Although excess deaths in 2022 due to drought resemble those estimated in the 2017 to 2018 crisis, if conditions continue to deteriorate, by June 2023, overall deaths could reach 0.42 for every 10,000 people every day. In other words, the authors forecast that the current drought may go on to surpass the 2017 to 2018 crisis in terms of peak death rate, duration and lives lost.

The team conclude by highlighting that immediate action is needed, with a vital emphasis on the significant efforts required to improve conditions if death rates are to return to those seen before the crisis.

Co-author and Professor of Epidemiology and International Health at LSHTM, Professor Francesco Checchi said: “Our findings suggest that tens of thousands of Somalis lost their life in 2022 due to drought conditions, with this toll set to increase in 2023. This is in spite of Somalis' own resilience, support by Somali civil society within and outside the country and a large-scale international response. Far from being scaled back, humanitarian support to Somalia must if anything be increased as the year progresses, and sustained until Somalia exits this latest crisis.”

Co-author and Schmidt Science Fellow at LSHTM and Imperial College London, Dr Oliver Watson added: “In the face of Somalia's harrowing drought and hunger crisis, we estimate that 43,000 lives were tragically lost in 2022, with children under five uniquely impacted and constituting half of these casualties. The unrelenting droughts have created one of the most severe hunger crises in 70 years, demanding urgent humanitarian action. To prevent an even greater catastrophe, a multi-sectoral response is desperately needed to alleviate this dire situation and prevent further loss of life.”

Publication

Watson et al., Mortality patterns in Somalia: retrospective estimates and scenario-based forecasting

Further information

This report, published today (20th March) is the first in a planned series on the current drought crisis in Somalia. Future editions will aim to improve the accuracy of the estimates reported herein, as well as providing retrospective estimates for projected excess deaths modelled between January and June 2023.

The project is funded by UNICEF and the World Health Organization.

A copy of the press release on the WHO website can be found here.