Cameroon’s Constitutional Council this week confirmed President Paul Biya won an election held earlier this month, winning 53.7% of the vote. This handed the 92-year-old another seven-year term. Runner-up Issa Tchiroma Bakary took 35.2%. The decision is final and not subject to appeal.

Biya has been in power since 1982, when he became the country’s second president, and is the world’s oldest head of state as well as being the longest-serving non-royal head of state.

Unrest broke out soon after the announcement of Biya’s victory. Security forces deployed in Douala, the country’s largest city and economic hub, used water cannons and tear gas to break up crowds after opposition calls for nationwide protests. Authorities say troops fired live rounds and at least four protesters were killed. Nearly 100 people were arrested, according to official tallies.

Frustration runs deep. Many Cameroonians are frustrated with stagnating growth, corruption, rising living costs, and persistent insecurity in parts of the country. Young people, who have known no leader other than Biya, have been especially visible in calls for change.

Biya’s 43-year rule looks set to continue, but questions now turn to governance, succession, and whether the state can contain dissent without further bloodshed.