One Health and antimicrobial resistance in Somalia: policy insights from Centennial Vision 2060

Objectives This study aimed to assess the extent to which Somalia's Centennial Vision 2060 (CV2060) provides a strategic framework for addressing antimicrobial resistance (AMR) and advancing a One Health approach. Unlike previous epidemiologic assessments, this study uniquely positions AMR containment as a function of state-building, focusing on governance, human capital, and health system integration. Methods A qualitative document analysis was conducted on the official English-language version of CV2060, treating the policy as a social fact. Using the Walt and Gilson policy triangle framework, the analysis examined the document across four dimensions: context, content, actors, and process. To ensure methodologic rigor, the text was independently coded by two reviewers against three predefined domains, with discrepancies resolved through consensus. Data were managed using a matrix analysis approach. Results Analysis revealed four inter-related themes relevant to AMR: (1) strengthening health system governance and regulatory capacity, (2) human capital development in health and veterinary sectors, (3) integrated One Health vision, and (4) digital transformation and data systems. Specific policy levers identified include the potential for digital import tracking to monitor antibiotic consumption and the use of judicial reform to criminalize unlicensed pharmaceutical sales. Although AMR is not explicitly mentioned, CV2060 provides foundational mechanisms that can support AMR prevention. Conclusions CV2060 establishes a scientifically and operationally viable framework to support AMR mitigation and One Health integration in Somalia. To operationalize this, the study recommends establishing a cross-sectoral AMR steering committee within the CV2060 implementation unit and explicitly integrating antimicrobial stewardship competencies into the proposed national curriculum.