CAMEROON: A HEALTH UPDATE

UNCLAS SECTION 01 OF 02 YAOUNDE 000865 SENSITIVE SIPDIS DEPT FOR AF/C, ACCRA FOR JEANNIE FRIEDMANN DEPT FOR USAID USDOC FOR ITA - K BURRESS E.O. 12958: N/A TAGS: KHIV KOCI SOCI PGOV CM SUBJECT: CAMEROON: A HEALTH UPDATE REF: A. 08 YAOUNDE 877 ¶B. YAOUNDE 357 ¶C. YAOUNDE 703 ¶1. (SBU) SUMMARY: The Government of Cameroon (GRC) has not yet offered a solution to a possible anti-retroviral drug (ARV) shortage, although the Central Drug Depository may use its reserves to finance ARVs for additional quarter. Although four H1N1 cases were reported in August, the Pasteur Institute has confirmed that no additional cases have been reported. Cameroon was recently included in a USAID-funded project covering Neglected Tropical Diseases, implemented in-country by Helen Keller International. A cholera outbreak in the Extreme North and North regions has reportedly left 19 dead, according to government sources. END SUMMARY. ARV Crisis Still Looming -------------- ¶2. (SBU) As reported ref B, Cameroon faces an imminent shortage of anti-retroviral (ARV) drugs, likely to affect about 60,000 people living with HIV/AIDS, who have until now had access to free ARVs. The GRC has not actively sought a solution to this shortage in past months. The government held a roundtable for large-scale business owners, requesting public-private partnerships to cover some ARV funding costs. After much prodding from international donors and a three month delay, Cameroon's Global Fund Country Coordinating Mechanism (CCM) submitted a Continuation of Service request to the Global Fund in late September. This request would fund current ARV patients for the next two years, but would not fund any new patients requiring treatment. The CCM hopes to receive an answer in the next few weeks. The GRC does not currently have a action plan for how to deal with new patients, nor for what it will do if the Continuation of Service request is denied. ¶3. (SBU) There are sufficient first line ARVs in stock until late November. CENAME, the Central Drug Depository, is holding past due bills for recent ARV shipments. Round 3 of the Global Fund is funding 50% of ARV costs, with the GRC footing the bill for the rest. The GRC has not been paying its share of recent bills, leaving CENAME to pay the balance. Sources in the Ministry of Health told poloff that the Prime Minister ordered the Minister of Finance to pay 5 billion FCFA ($ 10 million) to CENAME in early August, but no money has been allocated so far. CENAME staff recently told poloff that CENAME is considering using its reserve money to fund the next shipment of ARVs, thus avoiding interruption of treatment for patients. H1N1 - No New Cases -------------- ¶4. (U) Although four H1N1 cases were reported in August (reftel C),no additional cases have been reported to Cameroon's Office of Disease Control nor verified by the Pasteur Institute. Neglected Tropical Diseases -------------- ¶5. (U) USAID recently awarded Helen Keller International with a large, multi-year grant to fight neglected tropical diseases, such as river blindness, in Cameroon. The program will work at a community level to increase awareness, community action for prevention and treatment for several diseases prevalent in Cameroon. Cholera Outbreak -------------- ¶6. (U) A cholera outbreak has been unfolding over the past week in the Extreme North and North regions. The government reports 110 cases and 19 deaths as of October 13. Post has issued a warden message raising awareness of this issue. ¶7. (SBU) COMMENT: The GRC appears to have done a reasonably good job of tracking the H1N1 and cholera situations. However, its inaction on the looming ARV crisis is very unsettling. The government appears to relying on reserves to put the maximum pressure on donors to come up with the funds to fix the problem. Post has raised this issue multiple YAOUNDE 00000865 002 OF 002 times with high level officials. International donors are increasingly frustrated, especially as several organizations have offered to send consultants to work on this issue. Cameroon's Round 9 proposal to the Global Fund, submitted in June 2009, is almost one-fifth of the total Global Fund budget, and is therefore unlikely to be funded. We will continue to monitor the ARV and cholera situations. END COMMENT. PETERSON