28-year-old Ferdinant Mbiydzenyuy shares his insights on the NCD situation in Cameroon, his experience of setting up and working as Program Coordinator for the Cameroon Baptist Convention Health Services (CBCHS) NCD Prevention and Control Program, and what drives him to keep going. 

Today, NCDs are responsible for 70% of deaths globally, with most occurring in low- and middle-income countries (LMICs). 34% of annual deaths in Cameroon are currently due to NCDs, and this number is rising. 

These numbers are worrying, but not the only reason for me working in the NCD domain; instead, my own past experiences nursed the passion that drives me to tackle NCDs. In 2008, my aunt died because of complications from diabetes. Then in 2009, my university lecturer gave us two firm reasons why we should not work in the domain of cardio metabolic illnesses: The first was that there is no money in it, and the second was that results are hard to obtain in this domain for researchers.  While many students were drawn into these statements, and chose to focus elsewhere, it spurred me on – to me there was no better way to understand the plight of my aunt, and certainly thousands more, who died from diabetes complications. I immersed myself in the domain, with the understanding that if I had discovered the cure for diabetes, I would’ve prevented her death. I then, in the sad solemnity of my thoughts, committed myself to work on NCDs, not even knowing they would one day be called “NCDs”. 

In 2013, while I was working as a Grants Officer with the Cameroon Baptist Convention Health Services (CBCHS), I stumbled on the WHO’s 2008-2013 Action Plan on NCDs. Upon a closer look, I realized that my calling had found me. The Action Plan fuelled my passion and I approached the Director of CBC Health Services. With his leadership, support and inspiration, the NCD Prevention and Control Programwas finally established in 2016 as the first comprehensive NCD prevention and control program to be operated by a recognized leading health services non state actor and in Cameroon. 

Cameroon’s first comprehensive NCD prevention and control program

The mission of the NCD Prevention and Control Programis to help prevent illnesses, disabilities and deaths from preventable NCDs through innovative prevention, treatment and rehabilitation interventions in Cameroon. I currently work with a team of five talented and creative young people and more than 37 others in 6 regions of the country. We interact with communities to implement the program systematically through a Program Guide and a 3-year Strategic Plan.

We work with 7 key components: Awareness, Screening, Management (Hospital Care), Capacity Building, Surveillance, Advocacy and Research. Each component has its own specific activities.

In Awareness, for example, we have engaged in the “Know Your Numbers” (KYN) campaign since July 2017.  The KYN initiative promotes awareness on the burden, risk factors and prevention of NCDs and also does risk exposure assessment to improve health choices in 7 health districts in five regions of the country. 

In terms of Management, the program has reformed 10 diabetes clinics, providing equipment, setting a policy to staff the clinics with trained diabetes educators, and establishing registers. We are also piloting an electronic data collection system for diabetes and hypertension in 3 of our major hospitals. This pilot will be the first in West/Central Africa, and will be very useful to scale up due to the need for data collection systems for NCDs in Cameroon and Africa. This initiative is supported by our partner the World Diabetes Foundation.  

In terms of more specific successes, so far, 13,000 people have been screened for NCD risk and counselled on healthy behaviours, while those with diabetes or hypertension were referred for further care. In March 2018 alone, 175 health care providers in Cameroon including physicians and nurse practitioners took part in the management, diagnosis and appropriate referral of NCD cases.

In Advocacy, the program has established meaningful relationships with several national and global organizations. The CBCHS is now a member of the National Multisectoral Committee on NCDs and the Coordinator is involved in other networks as a result of participation in international conferences and dialogues. Recently, the Cameroon NCD Alliance which we have advocated for since 2016, was created during the Conference on Diabetes and other NCDs in West/Central Africa with myself as Coordinator. We will be engaged in the next three months in elaborating its objectives and engaging national stakeholders towards the UNHLM and beyond. 

Challenges are many, but the opportunities within them are great!

There are many NCD challenges in Cameroon, but one of the greatest I see is that many young people do not turn up for screening, when unfortunately, they are most vulnerable and need these services most. This shows that we need to increase our focus on youth participation in NCD activities. Access to NCD medicines is also a huge problem, due to poverty and the fact that NCD patients have to pay for care out-of-pocket. There is little financing for NCDs, and for a community based organization, it is challenging to achieve the plans already set for NCD prevention and control due to our limited resources. There is also a huge gap in human resources for health. Another major challenge has been the difficulty in completing the national Multisectoral Action Plan (MAP), due to financial limitations at the level of our NCD unit at the Ministry of Health.

There is a vast health inequity as far as diagnosis, management and referral of NCD cases in most health facilities in the country is concerned. There are insufficient efforts towards screening and early diagnosis and patient agenda setting and follow up. Most patients seen in the hospital come at advanced stages of diseases when they are much more difficult to effectively treat. These challenges greatly illustrate the reality of inadequate political commitment to responding to the voices of people living with NCDs.

Despite political and system challenges, youth and networks present potential

Despite many challenges, we see great potential in building a strong national NCD network for the sake of patients and the population at large through a Cameroon Civil Society NCD Alliance. There is a huge opportunity for us to mobilise young people, and as a member of the Young Professionals Chronic Disease Network (YP-CDN), there are discussions taking place to increase their engagement in Cameroon. We also see opportunities to further engage civil society for NCD work, as well as to work with the government and its stakeholders as a major partner to complete the MAP, elaborate ways forward for this very important health domain and implement WHO Best Buys for NCD prevention and control. 

The situation we find ourselves in in Cameroon is definitely challenging, but for me I find energy when I join up with others committed to the domain. Together, opportunities to collaborate become illuminated, and I feel optimistic that together we will find more ways to move forward and achieve what we are all setting out to achieve: less death and struggling from NCDs. 

About the Author

Ferdinant Mbiydzenyuy (@ferdinantmbiy) is 28 years old and is currently the Program Coordinator for the Cameroon Baptist Convention Health Services (CBCHS) NCD Prevention and Control Program, one of the largest and most comprehensive efforts on NCDs in the country.  The CBCHS is a recognized nonprofit, faith-based health services delivery organization with a vision to deliver quality health care to all who need it as an expression of Christian love. Currently CBCHS runs a network of 78 health facilities in 7 of the 10 regions of Cameroon and health promotion and rehabilitation services in all 10 regions of the country.