Cameroon has the highest HIV prevalence in West and Central Africa with an estimated 491,834 people living with HIV (PLHIV), including 30,456 under 15 years of age, and a steady decline in HIV prevalence . As of June 2021, Cameroon had reached 82-95-91 of the UNAIDS 95-95-95 treatment targets attributable to the expansion of the PEPFAR clinical program support from four to all ten regions since 2019. Despite these considerable progress, Cameroon’s laboratories do not yet offer optimal services nationwide to achieve HIV epidemic control. Before 2019, PEPFAR supported the Southwest, Northwest, Centre, and Littoral regions only, consequently, the laboratory infrastructure, systems, diagnostic services, and human resource capacity in these regions are more developed than in the remaining six regions. Access to quality diagnostics and laboratory services is critical and plays a central role in achieving UNAIDS 95-95-95 targets.
The CBCHB, an indigenous faith-based organization that has worked on the HIV/AIDS response in Cameroon for 27 years in partnership with the MOH, runs a comprehensive HIV/AIDS program using evidence- and results-based approaches adapted to the local context and implemented to optimize the use of resources. CBCHB achieved the first ISO-accredited laboratory in Cameroon, the National Early Infant Diagnosis Reference Laboratory (NEIDRL) with CDC support. CBCHB currently supports the clinic-lab interface in 80 PEPFAR-supported facilities in Cameroon’s Zone 1 and works with the CDC-funded GHSS to strengthen three reference laboratories: NEIDRL in Mutengene, the TB lab in Bamenda, and the DREAMS lab in Dschang.
Under this five-year CDC/PEPFAR NOFO, the experienced CBCHB consortium(FHI360, UW DIGI program and CRHISS Foundation), will build upon the foundation PEPFAR has established in Cameroon, using advances and best practices from similar projects in Cameroon and other countries in to 1) harmonize, operationalize, adhere to, and utilize laboratory-related national policies, QMS guidelines, and POC CQI, 2) expand and train the laboratory workforce to conduct, monitor, and provide efficient corrective action for quality assurance (QA) and EQA on HIVRT, VL, CD4 ,and TB testing, 3) increase access to testing for HIV and other related tests, optimize sample referral networks to ensure appropriate placement, maintenance, and supplies of POC instruments and to ensure complementarity with conventional platforms 4) strengthen Lab-clinic interface, accredit more laboratories, synchronize laboratory information systems and reduced turnaround time from sample collection to return of results from the current one month to two weeks .
We anticipate to provide support and technical assistance during Years 1 and 2 to build capacity in local agencies and laboratories and to position CBCHB as a strong laboratory partner in Cameroon. As local organizations pass through gates that demonstrate their readiness, we will shift to oversight and mentoring roles during Years 3-5.