Post 9/11 Somalia: the strategic role of health systems strengthening in global security

In the post 9/11 era Somalia is a country of particular international significance as a zone of Islamic fundamentalism international maritime crime and poor human health. There has been a sharpening of global focus on the country’s development and stability since 9/11. It is against this backdrop that the authors analyze the significant incremental improvements in healthcare in Somaliland as to see how 9/11 impacted Somalia’s place in the international policy arena what influence this has had on health and to reflect on the possible impact of health systems strengthening in the region on future global security. This article provides a brief overview of the variety of issues that create this instability in Somalia (and Somaliland) including its post-independence political instability acts of terrorism and the presence of Al Qaeda piracy and external investments. As a result of all of this health inequalities in Somalia even compared to other parts of sub-Saharan Africa are profound. These problems are further compounded by the migration of the already limited healthcare workforce and the perpetual security risk to the healthcare infrastructure for delivering services. However a paradigm of hope exists in Somaliland a relatively stable autonomous region in the northwest of Somalia. In healthcare this relative political stability has taken place in three principal pillars: strengthening health institutions delivery of an essential package of health services and training of qualified healthcare professionals. Regional differences in stability have facilitated the implementation of some international long term attempts to strengthen the health system in parts of the country with some degree of success. Such strategic health capacity building is seen as one of the essential cornerstones in a post conflict country.