After claiming independence from Belgium in 1962, Burundi became one of the most economically and socially advanced countries in Sub-Saharan Africa, despite periodic episodes of ethnic violence.

But the civil conflict that started in 1993 began a vicious cycle of violence and impoverishment which left the country with 300 000 dead and 1.2 million refugees or internally displaced persons, representing 16% of the population. This conflict, together with the effects of a regional economic embargo from 1996 to 1999, resulted in a 10 year decline in the national economy. The Gross Domestic Product per capita fell from 180$ in 1993 to 83$ in 2003, becoming one of the lowest on the continent.

In August 2000, a peace and reconciliation agreement was signed, and a transitional government was formed in 2002 in accordance with the conditions of this agreement. The phase of political transition ended positively in 2005 with a new constitution adopted by national referendum in February, successful municipal elections in June and parliamentary elections in July. Pierre Nkurunziza, leader of the former rebel faction CNDD-FDD, was elected president by the new Parliament and was sworn in on August 26th 2005. Despite this progress, the Hutu FNL continued to resist national armed forces until a first cease-fire agreement was negotiated in September 2006. The FNL resumed fighting when negotiations failed.

At the end of May 2008, a new cease-fire agreement was signed by all rival factions including exiled leaders, in particular, Agathon Rwasa, leader of the FNL. All parties are now participating in these most recent negotiations. Although a cease-fire is the first step to reconciliation, disarmament remains a difficult task. By the end of 2008, all observers became worried about increasing internal tensions and feared that the peace process could be compromised by the arrest of various political leaders and figures in the media.

Sources :
(*) Epidemiological Fact Sheet on HIV and AIDS 2008 WHO-UNAIDS-UNICEF, Juillet 2008
(¤) PNUD, Rapport sur le développement humain 2007/2008

According to UNAIDS, the prevalence rate of HIV was 3.3% in 2006 (Report on Aids epidemic, November 2007). The UNAIDS-WHO-UNICEF prevalence rate for adults had declined to 2,97%, in July 2008 while estimated national data continued to be 3.5% (165 700 people infected by HIV, numbers provided in the Global Fund proposal for the 8th Round).

Sources :
(*) Epidemiological Fact Sheet on HIV AIDS WHO-UNAIDS-UNICEF 2008
(#) Activity report on HIV-positive patient management in Burundi, national data, October 2008.

The fight against HIV/AIDS is organized around several actors in Burundi: :

• The National Committee for the Fight against Aids (CNLS): its mission is to provide the general orientations and coordinate the national policy of the fight against HIV/AIDS; to assist and support the government in implementing its actions against HIV/AIDS on the national level, and to deliberate upon questions concerning the preparation, implementation execution and regulation of these actions. A Permanent Executive Secretary (SEP/CNLS), the technical head of this committee, is in charge of the executing these activities against AIDS. www.cnlsburundi.org

• Two departments at the Ministry of Health :
  
  • The vice Ministry for the fight against HIV/AIDS
  • The sector unit for the Fight against AIDS (ULSS)

• The National Institute for Public Health (INSP) is the only laboratory with a machine to test viral load in Burundi.
• The Country Coordinating Mechanism (CCM) is the coordination committee for the Global Fund. It is presided by the Minister of Public Health and the Fight against Aids, assisted by two Vice-presidents from the private sector. It is a 33-member multi-sector team (10 representing the government sector and 23 for the private sector)

Associations play a crucial role in the fight against HIV/AIDS especially the SWAA, the ANSS and the APECOS which opened the first ARV dispensaries in Burundi. The ABS (Burundi alliance against AIDS) network has 214 member associations and the RBP+ (Burundi network for PLwH) is a national organization of people living with HIV/AIDS whose mission is to “give PLwH and people affected by the virus a voice and to stimulate the emergence of an effective response to the pandemic, by promoting the improvement of policies and practices, respecting Human Rights and Gender Rights.” Faith-Based Organizations also play an important role, in particular Caritas, which supports many medical/healthcare centers, and some religious groups, mainly from Italy, which have opened hospitals that have become reference centers in the provinces.

The government of Burundi has made universal access to treatment the backbone of its policy in the fight against HIV/AIDS. It also adheres to the key principles of the UNAIDS recommendations of the “Three Ones”: One Coordination Body (CNLS), One National Strategy Plan (PSNLS) and One National Monitoring and Evaluation Plan.

The National Plan against AIDS 2007-2011 has 4 strategic goals:

• Reducing the transmission of HIV/STD by consolidating and expanding effective prevention activities: reducing sexual transmission by promoting safe sexual behaviors, reducing transmission through blood, reducing mother-to-child transmission.
• Improving the well-being and the quality of life of people living with HIV/AIDS (PLwH) by reducing its impact on health, through prophylaxis, diagnosis and the treatment of opportunistic infections, and the psychological and nutritional follow-up of PLwH to improve compliance and the approach to treatment.
  
• Reducing poverty and other factors of vulnerability to HIV/AIDS: improving the social and economic situation of PLwH and people affected by HIV/AIDS, promoting the rights of PLwH and other vulnerable groups.
• Improving the management and coordination of the national response against HIV/AIDS: improving the data information system to manage the national response, coordinate a decentralized multi-sectorial approach and support the implementation, mobilization and management of financial resources.