This study reviews aid flows to the health sector in Somalia over the period 2000-2006. In close collaboration with the Health Sector Committee of the Coordination of International Support to Somalis the authors collected quantitative and qualitative data from twenty-six international agencies operating in Somalia, including bilateral and multilateral donors. The paper reaches three main conclusions. First, aid financing to the health sector in Somalia has been constantly growing, reaching US$ 7-10 per capita in 2006. Although this is a considerable amount compared to other fragile states, it may still be insufficient to address the population s needs and to meet the high operational costs to work in Somalia. Secondly, contributions to the health sector could and should be more strategic. The focus on some vertical programs (e.g. HIV/AIDS and malaria) seems to have diverted attention away from other important programs (e.g. immunization and reproductive health) and from basic health system needs (infrastructure, human resources, etc.). The third conclusion is that more analytical work on health financing is needed to drive policy decisions in Somalia. Similarly to other fragile states, quality information on health sector financing is scanty, thus affecting the policy making process negatively.

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