Based on the results from 25 integrated food security, nutrition and mortality surveys conducted by the Food Security and Nutrition Analysis Unit (FSNAU) and partners in June and July 2022 and subsequent IPC acute malnutrition analysis conducted in August, the total acute malnutrition burden for Somalia from July 2022 to June 2023 is estimated at approximately 1.8 million children under the age of five years (total acute malnutrition burden), representing 54.5 percent of the total population of children, face acute malnutrition through the mid-2023, including 513 550 who are likely to be severely malnourished. 

Acute malnutrition is already at Critical levels in many areas of central and southern Somalia, and the number of acutely malnourished children being admitted to treatment centers is rapidly increasing, with two to four-fold increases reported in some districts. Worsening food security conditions and limited access to clean water have led to outbreaks of acute watery diarrhea/cholera (AWD) in many areas. Coupled with an increase in measles cases, disease incidence is contributing to rising levels of acute malnutrition, reflected in the rising number of moderately and severely malnourished children admitted to treatment centers. Acute malnutrition case admissions among children under age five rose significantly in 2022 compared to the preceding three years.

Levels of mortality (both the Crude Death Rate (CDR) and the Under-Five Death Rate (U5DR) have surpassed Emergency (IPC Phase 4) thresholds in several areas.

Urgent funding to prevent famine and address the high levels of acute food insecurity across Somalia
Recognise the extreme urgency of the situation and plan, coordinate, and allocate necessary humanitarian resources to prevent a famine in the coming months. The early warning signs are clear, and all key stakeholders have a strong consensus that current levels of committed humanitarian support are inadequate to stave off further increases in massive human suffering and mortality. 

Urgent lifesaving humanitarian response
Stop and reverse the inexorable deterioration of the food security and nutrition situation in the coming months, by mobilising and providing urgently needed and coordinated assistance in the form of critical life-saving food and cash assistance, combined with an immediate scale-up of the response in the nutrition, WASH and Health sector. 

Livelihood support
Considering communities’ significantly diminished resilience, the high vulnerability to shocks and the protected nature of food insecurity and malnutrition, close collaboration between humanitarian and development programmes are needed to tackle the underlying causes of food insecurity and malnutrition and enhance resilience.

Scale-up nutrition interventions
Implement blanket supplementary feeding in the most affected areas to protect children and women from acute malnutrition given the projected worsening of an already precarious situation. Deploy a multi-sectoral approach to address the nutrition situation by incorporating livelihood/resilience activities into multi-sectoral nutrition response. Further scale-up of mass screening, integrated outreach services, coordination and nutrition surveillance accross Somalia.

Promote de-escalation of violence and facilitate response
The parties to the conflict in Somalia must allow and facilitate rapid and unimpeded passage of humanitarian relief for civilians, especially those most in need, which is impartial in character and conducted without any adverse distinction, subject to their right of control.