A pilot HIV/AIDS project in Cameroon is working to switch patients who have developed resistance to their first-line antiretroviral (ARV) treatment regimen to second-line treatment.

The first people to be put on ARV treatment in Cameroon started in 2000, and the country now has a longstanding group of patients on treatment. About 10 per cent of all people on ARV treatment develop resistance to the medication after a number of years, according to a study carried out by Médecins Sans Frontières in Douala, Cameroon’s largest city. These patients need to switch to a second-line protocol in order for their treatment to remain effective. However, second-line treatment is generally unavailable in developing countries, primarily because of its prohibitive cost.

In Nylon District Hospital, Douala, Médecins Sans Frontières supports a pilot project for the country that helps switch patients to second-line therapy. Our team is providing medical expertise, training, medication and advocacy, and hopes that the project will help prove the feasibility and necessity of implementing second-line treatment in developing countries. Fifty-eight patients began this lifesaving treatment in the last months of 2010.

Staff are also working to improve care for those still on first-line treatment, replacing the most widely used type of medication with one that has fewer side effects, and should result in fewer patients developing resistance. In 2010, 295 people began ARV treatment on the new medication and 187 patients were transferred to the new medication.

Buruli ulcer

Buruli ulcer is an infection related to leprosy and tuberculosis, which can cause painful wounds and physical deformations, and often leads to social stigma for people with the disease. Early diagnosis and treatment are vital to prevent irreversible deformities, but treatment is complicated, expensive, and can take over a year, involving antibiotics, skin transplants, special wound dressings and physiotherapy.

Since 2002, more than 1,000 patients have been treated at Médecins Sans Frontières’ programme in Akonolinga, a town in central Cameroon. We have set up a “Buruli pavilion” in the town’s hospital, where 120 patients received care in 2010, and also conducting outreach activities from the pavilion so that people living further away can access care more easily.  In 2010, the Ministry of Health declared the pavilion a national reference point for the treatment of Buruli ulcer.

Cholera outbreak

Cholera is endemic in the far north of Cameroon. But an outbreak that began in early May, and which also affected the neighbouring countries of Chad, Niger and Nigeria, infected far more people than usual. In Cameroon, Médecins Sans Frontières assisted the authorities’ response by donating sanitation and medical supplies, setting up and managing two cholera treatment units in the towns of Maroua and Mokolo, and supporting units in Kolofata and Mogode with expertise in hygiene and case management. Between May and September, 6,200 cases were registered in the region of Extrême Nord, and 410 people died from the disease.

Médecins Sans Frontières has worked in Cameroon since 2000.