But this year’s election, held on Oct. 7, took place in unusual circumstances: Since 2016, the central African country, a key U.S. security partner, has been teetering dangerously on the brink of civil war between English-speaking separatists and its government, dominated by French speakers.

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Elite circles in Cameroon are largely controlled by Francophones, while Anglophones are routinely overlooked for top ministerial jobs. There have been complaints about such marginalization for decades, but unrest broke out in late 2016 after Anglophone citizens complained that more and more Francophone teachers and judges were being sent to teach in their schools and preside in their courts.

The military responded violently to Anglophone protests, killing some demonstrators and rounding up others. The harsh reprisals only enraged Anglophones, who have given growing support to an armed movement trying to create an English-speaking breakaway state called Ambazonia.

In September, Amnesty International reported 160 members of Cameroon’s security forces had been killed by armed separatists since the conflict began. Around 400 civilians have been killed over the past year by armed groups on both sides of the conflict, and schools have become a common target.

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That isn’t the only crisis Cameroon has on its hands. For years now, the country’s Far North region has struggled to contain the threat of Boko Haram, the Islamist group that has terrorized the area and displaced many Cameroonians. About 300 U.S. soldiers are on the ground there to aid Cameroon in its anti-extremist operations.

As the International Crisis Group said in a report before the Oct. 7 election, “the political climate is tense, the economy shaky and much of the country insecure, torn between Boko Haram in the Far North and a conflict in the Anglophone regions in the Northwest and Southwest.”

Biya is one of a number of African leaders who have found ways to cement their hold on power even as their countries spiral into unrest. In Uganda, President Yoweri Museveni has been in power since 1985 — and last year, the Ugandan parliament repealed a presidential age limit that would have prevented the aging leader from running for reelection. In Burundi in 2015, President Pierre Nkurunziza ran for a third term that his opponents insisted was unconstitutional, sparking unrest that displaced hundreds of thousands of people and left many others dead.

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Aside from the tension surrounding the election in Cameroon, the validity of the vote itself appears suspect. This week, Cameroon’s constitutional council said voter turnout was at 54 percent. But between the violence and the displacement it caused, it’s unlikely that so many voters were able to make it to the polls.

There's also suspicion of fraud about the votes that were cast. According to the official tally, Biya took 71 percent of the vote and even did well in some Anglophone areas where he has little support. Maurice Kamto, the next-closest runner-up, took only 14 percent of the vote.

Even Cameroon’s state-run television channel found itself in an awkward position after reporting Transparency International was in the country observing the elections — a claim the organization later refuted. “A deliberate attempt to impersonate Transparency International or knowingly portray non-affiliated individuals as employees of the anti-corruption watchdog is completely unacceptable,” the watchdog group said in a statement.

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All of this has reinforced suspicions that the vote was rigged from the get-go. Kamto said in a statement that he would “solemnly and categorically reject these manufactured results and refuse to recognize the legitimacy of the Head of State.”

"We will use all means of law to restore the truth of the ballot box,” he said.

The United States considers Cameroon an important partner in a somewhat unstable region, and State Department spokeswoman Heather Nauert congratulated Cameroon after the vote on its “largely peaceful elections,” while noting that there “were a number of irregularities prior to, during, and after” the vote.

With many Cameroonians seeing Biya’s win as fraudulent, the violence may get worse. This week, heavy fighting broke out between the military and separatists in the country’s northwest. The death toll is disputed, but the Associated Press reported that its journalist on the scene “saw at least 18 corpses.”

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The incident may be a harbinger of what’s to come: At least 160,000 people are displaced within the country and tens of thousands of others have fled into neighboring Nigeria. Frustrations are now mounting across the country, and the International Crisis Group warned in a report that “ordinary people’s opinions are increasingly radical.”

Biya manages to avoid dipping his toes too much in any of the chaos unfolding around him — an investigation by the Organized Crime and Corruption Reporting Project earlier this year found he has spent about 4½ years of his time in office abroad on “private trips.” After the election results were announced, he simply tweeted: “Thank you for your renewed and large confidence. Let us now join in taking up, together, the challenges that confront us.”

Those challenges could soon become larger than he’s able to tackle.