Cameroon held a presidential election Sunday that could extend 92-year-old Paul Biya’s 43-year rule by another seven years, potentially making him 99 by the end of the term.

Biya, in power since 1982, faces nine opposition candidates, including Issa Tchiroma Bakary and Bello Bouba Maigari, amid concerns about his age, health, and the country’s challenges.

Opposition figures and voters have raised fears of voter fraud and an unwieldy electoral process, though many, especially younger citizens, are hoping for change.

The election comes as Cameroon faces security crises, including an Anglophone separatist war and Boko Haram attacks in the north, with nearly half the population living in poverty, CNN has reported.

Results are expected by October 26, with the winner determined in a single round of voting.