Pandemic preparedness in unstable and conflict-affected states is mainly shaped by political, institutional and security constraints, not technical deficits. Prolonged conflict, chronic underinvestment, humanitarian crises and climate shocks interact to threaten global health security. Somalia represents an example of such a challenge. Decades of conflict, fragmented federal state governance, and recurring climate shocks have eroded the health system's capacity. These factors expose the country and public health to an acute risk of epidemics. Conventional preparedness frameworks often underestimate these interconnected issues.