Cameroon suffers from an inadequate healthcare system, with many communities lacking access to vital prevention measures, means for testing, and effective treatments against communicable and non-communicable diseases. Despite many diseases being preventable and treatable, this results in a large burden of disease, both in terms of morbidity and mortality. These effects are also due to insufficient knowledge of disease prevention and treatment, and stigma associated with the diseases, such as HIV.
Information on the current context of diseases in Cameroon can be found below the following links:
UNAIDS estimated that in 2021, 500,000 adults and children were living with HIV in Cameroon, with an estimated 13,000 people dying from AIDS (1).
In accordance with the third of the Sustainable Development Goals (SDGs), “ensure healthy lives and promote well-being for all at all ages” (2), UNAIDS produced the 95-95-95 fast track targets to eliminate the AIDS epidemic as a public health threat by 2030. These targets are that 95% of people living with HIV know their HIV status, 95% of people diagnosed with HIV infection received sustained antiretroviral therapy, and 95% of all people receiving antiretroviral therapy achieve viral suppression by 2025 (3).
Unfortunately, the 2022 Cameroon Country Operational Plan (COP22) for HIV/AIDS reported that only 85% of people living with HIV know their HIV status, 92% of those who know their status are on treatment, and 94% of those on treatment are virally suppressed. These estimates correspond to the national ART treatment coverage (number of people living with HIV who are currently on treatment) being just 78.5% (4).
HIV infection is unequally distributed in Cameroon, disadvantaging women, young children and key populations. UNAIDS estimates that of the 460,000 adults aged 15 and over living with HIV, over twice as many women are living with HIV as men (310,000 vs. 150,000)(1). 15,000 adults and children were reported to be newly infected with HIV, with the majority of these new infections among women aged 15 and over (7,300) and children aged 0 to 14 (4,300)(1). COP22 also found that whilst national prevalence of HIV is 2.7%, prevalence among key populations is significantly higher. HIV prevalence among female sex workers is 24.3% and 29.7% among men who have sex with men (4).
The Global AIDS Strategy 2021-2026 found that intersecting inequalities, such as those mentioned above, are driving the AIDS epidemic, and for every country and community to be on-track to end AIDS by 2030, these inequalities need to be reduced by 2025 (5).
HIV preventative measures such as the use of condoms, both male and female, and adherence to HIV treatment are proven to reduce the prevalence of HIV (6).
Malaria is the most widespread endemic disease in Cameroon. The WHO Malaria 2021 Cameroon Country Profile estimated 7.3 million yearly cases and 10,900 deaths (7). Malaria is disproportionately concentrated in children below the age of 5, with USAID’s Cameroon Malaria Operational Plan finding that in 2020, 31.9% of malaria cases were in children under the age of 5 (8). In 2022, malaria is a large contributor to Cameroon’s under-five mortality rate of 72.2 (number of children who die before their 5th birthday per 1,000 live births) (9).
Target 3.3 of the SDGs refers to infectious diseases and includes ending the epidemic of malaria by 2030. Target 3.2 includes ending preventable deaths of newborns and children under 5 years of age, as well as reducing under-five mortality rate to at least 25 per 1,000 live births (2).
The use of insecticide-treated mosquito bed nets and prophylactic medicines against malaria have been shown to reduce incidence of malaria infection (10).
The Coalition for Global Hepatitis Elimination estimated the number of people living with chronic hepatitis B (HBV) in Cameroon to be 1,271,830 in 2019, with 2092 HBV-related deaths (11). Despite the WHO recommending all infants receive a 3-dose vaccine against HBV, which is safe and offers 98-100% protection (12), coverage of 3-dose HBV vaccine in Cameroon was 69% in 2021 (11).
The number of people living with chronic hepatitis C (HCV) in Cameroon was estimated to be 767,995 in 2019, with 270 HCV-related deaths (11). Whilst there is no effective vaccine against HCV, prevention is achievable through reducing the risk of exposure to the virus, and antiviral medicines can cure over 95% of patients with HCV infection. Advances in direct-acting antiviral medicines mean that testing, care and treatment can be provided by trained non-specialist doctors and nurses, relatively cheaply (13).
Cameroon’s National Diabetes and Hypertension Program has stated that 9% of adults in urban areas are living with diabetes in 2022, increasing from 6% in 2021. The program also stated that 80% of patients are undiagnosed and only a quarter of people with known diabetes have adequate control of their blood sugar. COVID-19 coupled with insecurity resulting from Cameroon’s separatist conflict and terrorism near its borders with Nigeria and Chad, have prevented diabetics accessing life-saving treatments (14).
Soil-transmitted helminthiasis, more commonly known as intestinal worms, is a neglected tropical disease, which increases the risk of anaemia, intestinal blockages, as well as malnutrition, contributing in young children to weakened cognitive development and stunted growth (15). It was estimated that in 2016, more than 10 million Cameroonians suffer from intestinal worms, with school children being the most affected and most vulnerable group (16).
15. The Task Force For Global Health Intestinal Worms. Website accessed: 4th Jan 2023. https://www.taskforce.org/intestinal-worms/
Reduce incidence of HIV/AIDS, malaria, hepatitis B & C, diabetes and intestinal worms.
Improve knowledge of disease prevention measures in schools and communities.
Improve access to methods of disease prevention, testing, treatment and counselling.
The solution
Education on HIV prevention measures and sensitisation of HIV within schools and communities.
Provision of measures for HIV prevention, testing, treatment and counselling in schools and communities.
Provision of insecticide-treated mosquito bednets, and preventative prophylaxis to prevent malaria.
Education on malaria prevention measures, such as cleanliness.
Access to preventative measures such as hepatitis B vaccination and deworming tablets.
Access to testing and treatment of hepatitis B&C, diabetes and intestinal worms.
Our ongoing efforts
Numerous educational and sensitisation campaigns for HIV in secondary schools, universities and in local communities across Cameroon, which stressed the necessity of testing for HIV.
Distribution of male and female condoms as well as lubricants, with demonstrations of proper use of condoms on artificial genitalia, in collaboration with local and international partners.
Numerous educational and sensitisation talks regarding malaria within secondary schools, universities and in local communities. These talks focused on the importance of using mosquito-treated bed nets and practicing cleanliness to prevent mosquito breeding.
Distribution of insecticide-treated mosquito bed nets, largely in rural communities.
Challenges
We currently lack the adequate financial resources to proceed with several aspects of our healthcare programme:
Distribution of rapid diagnostic tests for HIV and malaria, which are vital for successful linkage of positive tests to healthcare treatment centres.
Distribution of prophylactic medicines to prevent mother-to-child transmission of malaria.
Undertaking of research into the acceptability of different HIV testing methods i.e. self-testing, community-based testing administered by a healthcare professional, testing within a healthcare facility.
Testing of diabetes and hypertension in communities to facilitate further medical care in healthcare centres.
Engage in the campaign to help fight mental health in Cameroon. Victims of mental health are often neglected at the initial stage; such individuals are misconstrued to be mad and their mild depression is allow to degenerate to a full mental illness and thus these poor victims go wild and roam the streets; a majority of such victims being women/youth who have suffered some form of GBV. We want to create awareness and connect people to the right channels to get their mental issues handled appropriately and timely. It is quite sad that mental health is forgotten health in Cameroon.
Equally, we are very willing to expand the scale, and the consequent impact, of our ongoing efforts, however financial resources remain the barrier.
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