Foodborne illnesses exert a substantial toll on public health and economic systems globally, with low- and middle-income countries
(LMICs) like Somalia being disproportionately affected due to fragile health infrastructure, limited regulatory oversight, and
high prevalence of informal food markets. This study assessed the prevalence and economic burden of foodborne diseases in
Somalia by integrating regional epidemiological data and cost estimates to compensate for national data gaps. Cholera remains
the most frequently reported illness, but evidence from sub-Saharan Africa suggests a broader burden of pathogens such as
Salmonella, Escherichia coli, and Campylobacter, whose surveillance remains underdeveloped in Somalia. Direct healthcare costs
are substantial, ranging from outpatient care to the treatment of severe complications, such as Guillain–Barré syndrome and
hemolytic uremic syndrome. Indirect costs include lost productivity, educational disruption, long-term disability, and exacerbated
poverty cycles. The impact on the livestock-driven economy is also profound, with repeated export rejections and trade losses
highlighting the vulnerability of Somalia’s food system. This perspective underscores the urgent need for enhanced surveillance
systems, regulatory harmonization, and investment in food safety infrastructure to reduce the disease burden and protect economic
stability.