Analysis of the hiv/aids situation in burundi

OXFAM INTERNATIONAL:
A Situation Analysis On The Hiv/Aids Epidemic In
Burundi and Oxfam International’s Potential Role In The
National Response To The Epidemic.
MARCH-APRIL 2003
Oxfam International affiliates working in East and Central Africa:Oxfam GB, Novib, Oxfam Ireland, Oxfam Solidarite, Oxfam Quebec Acknowledgement:
This document is the result of research work by AIDS specialist working then with projectGIPA, Dr. Françoise (The Principal Investigator), who drew inspiration from previousresearch work on HIV/AIDS in Burundi. Lynette Simon the programme coordinator, OxfamGB, Gitega was the leader of the OI HIV/AIDS working group in Burundi, which coordinatedthe study.
Volunteers did translations from French to English with Oxfam Solidarite, documentrefinement and editing done by Dr. Harriet Kivumbi Nkalubo, the regional HIV/AIDS policycoordinator for Oxfam International in East and Central Africa.
Finally appreciation to all OI partners in Burundi, for participating in the study and to OIaffiliates and all other actors for the support provided.
Contact persons:
1. Lynette Simon, Oxfam GB, Gitega B.P 391, Gitega Burundi,E-mail: 2. Dr. Harriet Kivumbi Nkalubo, Regional HIV/AIDS policy coordinator,Oxfam International in East and Central AfricaEmail: [email protected] Acronyms and Abbreviations
AAB
ANSS Association Nationale de Soutien aux Séropositifs et Sidéens (National AIDS-
HIV-victims support)
APSS Association des Prisonniers Séropositifs et Sidéens
(Association of prisoners (people living with AIDS)
ARV
Antirétroviraux (Anti retro viral therapy ) Association des Scouts du Burundi (Burundi scout association) Association Sans But Lucratif (Non profit making organisations) BRARUDI : Brasseries et Limonaderies du Burundi
(Burundi Breweries and lemonade producers)
BRB
Centre d’Entraide et de Développement (development and Aid Centre) Conférence Internationale sur le SIDA et les Maladies sexuellement
transmissibles (CISMA) en Afrique. (International AIDS/STD Summit in Africa)
COTEBU
Equipe de Prise en Charge (Support Organisation) Famille pour Vaincre le SIDA (Families against AIDS) Groupe Consultatif Pays (National Consultative Group) Greater Involvement of People infected or affected by AIDS Initiative Burundaise d’accès accéléré aux Traitements Antirétroviraux (Burundi initiative for access to ARV)
IEC
Mutuelle de la Fonction Publique (National public Health Service) Maladie Sexuellement Transmissible (STD Sexaully transmitted disease) OAC Organisation à Assise Communautaire (Community assembly Organisation)
ONG
PNLS Programme National de Lutte contre le SIDA
(National AIDS control program)
PNUD Programme des Nations Unies pour le Développement (UNDP United Nations
Development programme)
PTME
Prévention de la Transmission de la Mère à la l’Enfant (Prevention of Mother to child transmission of HIV/AIDS)
PLWA
Projet Régional du PNUD (UNDP Regional project) RBP+ Réseau Burundais des Personnes vivant avec le VIH/SIDA (Burundi network
for AIDS-HIV victims support)
SAO :
Fonds d’affectation Spécial (Special needs Fund) Syndrome d’Immuno Défiscience Acquise (AIDS Acquired Immuno Deficiency Syndrome) Support International Project against Aids in Africa (Anti-AIDS project support in Africa)
SWAA
Virus d’Immunodéfiscience Humaine (HIV Human Immunideficiency virus) Volontaire des Nations Unies (UN volunteer) Volontaire National des Nations Unies (UN national volunteer) Table of contents
Introduction
With the aim of developing strategies for mainstreaming HIV/AIDS in the variousprogrammes financed by Oxfam International (OI), OI commissioned an analysis of theHIV/AIDS situation in Burundi. This analysis was carried out in conjunction with a mappingof partners of OI in Burundi, to understand their HIV/AIDS programming capacities. It iswithin this framework that this work has been carried out, to enable OI to develop its strategicplan form a well-informed background.
This work is in two parts, but presented as separate reports:1) Component 1: Analysis of the HIV/AIDS situation in Burundi Component 2: Results of surveys carried out by Oxfam International’s partners in Study methods
Analysis of studies already undertaken and various documents, such as reports Analysis of data forms filled by OI’ partner organisations Meetings with Oxfam partners and the partners they work with Interviews with key actors in the fight against AIDS and OI partners.
Brief outline of the global HIV epidemic situation
According to the UNAIDS report of December 2002, the cumulative number of peopleinfected by HIV/AIDS is about 42 millions, of which 29.4 millions live in sub Saharan Africa.
Amongst those, 19.2 millions are women and 3.2 millions are children under 15 years of age.
It is estimated that out of the 5 million new HIV infections, 3.5 million occurred in sub-Saharan Africa. The number of deaths caused by AIDS in 2002 was estimated to be 3.1million, of which 2.4 occurred in sub-Saharan Africa. The total number of children orphanedby HIV/AIDS since the start of the epidemic is estimated to be close to 14 million. The globalepidemic of HIV/AIDS constitutes a global crisis and is one of the most threateningchallenges to human life and dignity, as well as for the full exercise of human rights. AIDShas compromised the economic development of the world and affects society at all levels:global, national, community, at family and individual levels.
HIV/AIDS epidemic situation in Burundi
Burundi is a Central African country of 27,834 km², with a population of about 6,565,000inhabitants. The urban population is about 9% while the population living in rural areas isabout 91%. Life expectancy at birth in the year 2000 is estimated around 41 years old.
In Burundi, the first AIDS cases were discovered in 1983. According to UNAIDSestimates, Burundi is ranked as number 15, among countries most hit by the HIV/AIDSpandemic. The average HIV sero-prevalence rates by the end of the year 2001 were estimatedat 8.3 % of the adult population (aged 15-49). AIDS has become the leading cause of death 1 ONUSIDA/OMS, le point sur l’épidémie de SIDA, december 20022 PNLS/MST, bulletin épidémiologique annuel de surveillance du VIH/SIDA/MST, July 2001 among adults and a serious cause of death amongst young children in Burundi. The numberof People Living with HIV/AIDS is 390,000 of which 190,000 are women (15-45 years) and55,000 are children between 0-14 years old. Women are more infected by the disease thanmen. The number of children having lost their mother, father or both parents because of AIDSbefore the age of fifteen, since the start of the epidemic up until 2001 reaches 240,000. Theestimate in the number of deaths caused by AIDS in 2001 was 40,000 .
Cross-sectional sero-incidence surveys not being easy to carry out, the HIV prevalencetrends are followed through sentinel surveillance amongst pregnant women aged between 15-24, attending antenatal clinics. The current trends show a declining pattern of new infections.
The 2002 national survey on sero-prevalence confirmed this observation. Data collection inBurundi has been getting better with time.
The data in tables 1 and 2 below show a tendency towards stabilisation, and even a decrease in urban areas and a tendency of rising prevalence in rural areas, especiallythe semi-urban areas. The differences observed in the rates of the last two years are notstatistically significant, they could be due to sampling fluctuations.
Table 1: HIV/AIDS trends in sentinel sites Burundi, 1995-2001
3 ONUSIDA/OMS, Rapport sur l’épidémie mondiale du VIH, 20014 PNLS/MST, bulletin épidémiologique annuel de surveillance du VIH/SIDA/MST, Juillet 2001 Table 2: Results of a national survey on the sero-prevalence of HIV in 20025
Sero-prevalence rates in
The HIV prevalence rates in urban areas (Bujumbura city-council) changed from less than 1%in 1983 , to 11% in 1990 and to 20% in 1996 amongst the adult population. As demonstratedin the above tables, the rates have been coming down since 1997. In 2001, it was 16% andaccording to a 2002 report, the prevalence rates were 9.4%. Efforts should now be focussedon awareness raising on HIV/AIDS in order to retain this low prevalence rates.
In semi-urban areas (Gitega Ngozi & Rumonge province city centres) the HIV/AIDSprevalence rates are worrying. The sero-prevalence in 2002 has been reported at 10.5%. Inrural areas, prevalence rates though low, are having tendencies of going up. The sero-prevalence, which was estimated at 0.7% in 1990, is now estimated at 2.5% according to the2002 report on sero-prevalence.
The high vulnerability of women living in urban areas and semi-urban areas is exhibited bythe doubling of rates. The sero-prevalence increases in women from the age of 16, while inmen the rate only increases from the age of 20. In rural areas youngsters aged 12 to 20 are themost affected. One has to keep raising people’s awareness, in order to keep the rates as low aspossible.
The sero-prevalence of HIV in blood donors is decreasing progressively, it was 7.3% in 1990and 0.2% in 2001. This demonstrates that the qualitative selection and maintaining ofvoluntary blood donors protects people who have to under go blood transfusions. On theother hand, 20,247 people in 2001 under went HIV/AIDS voluntary counselling and testing ofwhich 15.09% were found to be HIV positive. Condom distribution has remained low with2,616,464 condoms distributed in 1993 and 3,672,782 distributed in 2001, this is roughly onecondom per sexually active couple per year.
5 PNLS/MST, bulletin épidémiologique annuel de surveillance du VIH/SIDA/MST, Juillet 20016 PNLS/MST, bulletin épidémiologique annuel de surveillance du VIH/SIDA/MST, 19987 PNLS/MST, bulletin épidémiologique annuel de surveillance du VIH/SIDA/MST, 19988 PNLS/MST, bulletin épidémiologique annuel de surveillance du VIH/SIDA/MST, July 20019 PNLS/MST, bulletin épidémiologique annuel de surveillance du VIH/SIDA/MST, July 200110 PNLS/MST, bulletin épidémiologique annuel de surveillance du VIH/SIDA/MST, July 2001 Communities that are particularly vulnerable to HIV AIDS infection in BurundiAccording to the review of documents, sero-prevalence studies and the CAP survey of 2001,one can draw a list of people who are particularly vulnerable to HIV in Burundi, theseinclude: • Prostitutes (professionals or women who have multiple partners) • Displaced people and disaster victims • Militaries and people who wear uniforms • Certain single people, depending on the region Drivers and factors encouraging the spread of HIV/AIDS in Burundi To reduce the spread of HIV, there is a need of promotion of behaviour change amongst allcommunities. An efficient prevention of HIV/AIDS should reflect a change in people’sbehaviours, especially as to what concerns their sexual behaviours. But in Burundi, in general,the change of behaviour has been extremely slow.
• The precocity of sexual intercourse (sex at an early age), particularly amongst young • The extent to which people have multiple sex partners (including non polygamous • Unprotected penetrative sexual intercourse • The lack of information, counselling and targeted interventions for the prevention of HIV, including access to treatment of STDs.
• The lack of privacy in displaced people’s camps and in suburbs, especially the slums • Alcoholism and drugs that induce risky sexual behaviours such as the use of prostitutes, unfaithfulness and rape.
• Lack of communication within the families, between couples and parent-children on sexuality issues, which are regarded as a taboo • Lack of family support to orphans following their parents’ deaths.
• A weak network in terms of the marketing and the distribution of condoms.
• Geographic celibacy of certain categories of people (militaries, workmen, truck drivers etc.), which encourages the need for the affected men and women to have anumber of partners.
• The growing poverty of the Burundi population • The ongoing conflict: a socio-political crisis in Burundi • The break down in social links due to the socio-political crisis • The shifting of populations which give rise to poverty and despair • Feeling of lack of emotional and financial certainty • The low socio-cultural status of the Burundian woman • Traditional practices such as: “gutera intobo” (the father in law has sex with the son’s wife), “gusobanya” (a man sleeps with his sister in law in the absence of his brother),“gucura” (widow inheritance by the father or brother in law ).
• Religious beliefs: the use of condoms goes against most religious practices.
IMPACT OF HIV/AIDS
Impact on the health infrastructure and systems
The chronic illness associated with HIV/AIDS has led to a reduction in the quality of health
service provision and an increased mortality. 70% of hospital bed` occupancy is attributed to
HIV/AIDS, this has increased pressure and demand on the health infrastructure. The hospital
manpower has been incapacitated because nurses and doctors are also affected by the
pandemic.
Impact of HIV/AIDS on the structures and the education system
There is a low quality education services, low school enrolment because, teachers are
Sick and dying from HIV/AIDS, there is absenteeism from work, a decrease in the teaching
staff. Sick parents and the many AIDS orphans mean that
Impact of HIV/AIDS on the economic systems
HIV/AIDS affects mainly people in the economically productive years. In Burundi it is thehead of the family who are poor, not insured and without social security support that aremostly affected. HIV/AIDS leads to increase of costs of health care for households,companies, social security and state. The HIV/AIDS impact on the people’s productivecapacity has made direct impact on the agricultural sector, formal and informal private sector,the public at large.
Demographic impact of HIV/AIDS
The UNAIDS report projects that , life expectancy at birth in Burundi will go down from 46years of 1997 to 39 years in 2010.
Impact of HIV/AIDS on other social aspects
HIV/AIDS affects has severely affected families, death of the bread winner or one of theparents, has a consequence of loss of income and deprivation of survivors of the emotionaland material support. Orphans are a huge problem and on the other hand, women risk beingdeserted by husbands when HIV/AIDS positive status is discovered.
Responses to the pandemic: National HIV/AIDS priority programmes
Sixteen action programmes are in the 2002-2006 national HIV/AIDS strategic plan. Theseactions are divided into three main intervention axes. These programmes are described in amulti-sector and multi-dimension context. The programmes will be implemented by the non-profit making sectors and the public sector.
Table 3: A summary of the National strategic plan priority programmes
INTERVENTION
PRIORITY PROGRAMMES
A. PREVENTION OF
1. Reduction of risky sexual behaviour through IEC actions on selected THE SPREAD OF
HIV/AIDS
2. Social marketing of condoms.*3. HIV/AIDS screening and testing (promotion).*4. Early diagnosis and treatment of STIs.
5. Lowering of the risk of HIV/AIDS transmission by bloodtransfusions.
6. Prenatal screening and control of HIV/AIDS transmission frommother to child (promotion and information). B. CARE AND
7. Social and psychological care of PLWA.* SUPPORT FOR
8. Screening and treatment of opportunistic infections.
PLWA AS WELL AS
9. Better access to antiretroviral treatments against HIV/AIDS MITIGATION
10. Promotion of the links between health / human right / protection ofpersons living with HIV/AIDS and other vulnerable groups.*11. Care and support to HIV/AIDS orphans.*12. Activities that generate income in favour of the poor PLWA.* C. STRENGHTENING 13. Strengthening the surveillance, information collection and
THE
INSTITUTIONAL
14. Strengthening the capacities of development and follow-up of CAPACITIES FOR
ADMINISTRATION
15. Strengthening the capacities of civil society organisations, national, AND FOLLOW-UP
OF THE ACTION
16. Strengthening the national AIDS control committee (Conseil National de Lutte contre le SIDA - CNLS).
Out of the 16 programmes in the table above, OXFAM partners can contribute to variousextents in at least ten (10) programmes: namely 1, 2, 3, 6, 7, 9, 10, 11, 12 and 15.
Current programmes on HIV/AIDS and key actors
HIV/AIDS prevention interventions
Research of the epidemiological trends
Investigations about the knowledge, the behaviours and practices
Prevention of transmission through blood transfusions
Prevention of sexual transmission
Prevention of mother-to-child transmission.
Care and support of PLWA
The treatment of opportunistic infections using antiretroviral therapy, the cost of ARVs is
listed in appendix 4. The ARV drugs in Burundi are lower than those in Europe and
developed countries, because of the "ACCESS" programme, where government has
negotiated prices without taxes for the medicine. The government has also created a national
solidarity fund to improve access to care. Moreover, the generic ARV drugs are accessible in
Burundi. This care is made possible by the collaboration between the public and private
sector. Home care and day hospitalisation are primarily organised by community service
organisations.
Psychosocial support of PLWA : There are about 80 VCT centres with staff for
this purpose. There also are CSOs with programs that focus on psychosocial care of PLWA .
The care staffs are within the health structures, essentially public and private health centreswhere voluntary screening is provided. In total, 58.2 % of the communes in this country haveat least one centre for voluntary testing and counselling of HIV. VCT services made itpossible for 26,500 persons to benefit from the psychosocial services in 2000 – which israther a small number, compared to the target population of young adults. 7 provinces out of17 and 36 communes out of 121 already have community AIDS control networks. Appendix 5contains a list of screening centres where screening is done anonymously and is free ofcharge.
Reducing the impact of HIV/AIDS on individuals, families and the
community.
• Providing material, medical and nutritional assistance to the PLWA, providing education to orphans and promoting income-generating activities.
• Improving the legal environment so that rights of persons infected or affected by • Taking care of orphans – only about 230,000 orphans all across the country were taken care of by UNICEF and other non-profit-making organizations such as FVS orAPECOS.
• Leading micro-projects that generate revenue – this is an important programme for the vulnerable; better strategies ought to be found to reinforce these actions, so as toachieve better cost-effectiveness.
• Providing PLWA and other affected persons a better access to social services (this is currently limited to programs of the non-profit making organisations).
3) Programmes on HIV/AIDS and the work place
AIDS is a problem at the core of socio-economic development in general. It has not only agreat impact on infected individuals, but also their relatives, neighbours or colleagues at workare touched as well. The effects of HIV/AIDS reach national as well as internationalcommunities.
AIDS particularly affects the working sector because it reaches and kills the populationbracket, which is sexually active (15-45), which is also the most productive. This is whyprograms are currently being organized in the working environment to protect the most activepersons.
As part of this, HIV/ AIDS prevention and impact mitigation activities are promoted in somework places. HIV/AIDS workplace programs exist in 19 public and private institutions.
Policies of medical care for employees infected by HIV/AIDS exist in a few private and para-statals, national or international NGO’s. The response in the working environment arereinforced by actions of the GIPA project and other reinforcement programmes organized inthe context of the multi-sector AIDS control programme Key actors in the struggle against AIDS in Burundi
Actors in the struggle against AIDS include the public and the private sectors. See table 1 and2 in the appendices for the description of key actors in the fight against AIDS by province.
Mainstreaming of HIV/AIDS at the work place- institutions supported by the project
GIPA
Table 4 below shows the business communities where the mainstreaming of HIV in workplaces in collaboration with the UN project GIPA.
Table 5 shows employers who have initiatives for care and support of employees living withAIDS. Some of these institutions collaborate with the UN GIPA project. The strategicapproaches are different from one institution to another, as the table shows it below.
Table 4: Business communities that have HIV workplace programs
Institutions hosting UN
HIV/AIDS workplace programme activities at host
Volunteers of the project
GIPA
institutions
Table 5: Access to the ARV therapy through workplace initiatives
Organization
Beneficiaries
Source of ARV treatment funds
Insurance fund by employer andconcerned personnel Insurance fund by employer andconcerned personnel The COTEBU is also planning to set up ARV treatment fund in April 2003. The origin of thefunds will be mainly from the insurance fund, AMASICO Mainstreaming HIV/AIDS in development and humanitarian work.
There are few actors in Burundi who have policies for integration of the HIV/AIDS in
development and humanitarian work. The integration or the mainstreaming of HIV in
development is defined as the prioritising HIV/AIDS impact mitigation in development or
humanitarian programs, by considering the impact of HIV/AIDS on development and the
impact of development and humanitarian work on HIV transmission. The integration of
HIV/AIDS necessitates a change in the way the actors think, the policies, strategies and key
activities planned, executed, monitored and evaluated.
In Burundi the concept of HIV/AIDS mainstreaming, has mainly been developed by theUNDP. UNDP organized a training of trainers on the mainstreaming of HIV/AIDS. Othermainstreaming initiatives have been funded within the context of the UN GIPA project, inprivate and para-statals companies (BRARUDI, INSS, BRB, COTEBU, SOCABU) in theministries (Ministry of defence, Ministry of integration, re-integration of moved people andrefugees) in some project like the project of the AGETIP which is in conjunction with roadconstruction companies, to create awareness among workers for AIDS control; and in theNGOs (Catholic Relief Services, Oxfam GB and Action Aid).
An evaluation study by Action Aid on HIV mainstreaming in Ruyigi province, 2002 reportedthe following experiences;The process of mainstreaming HIV/AIDS included the following steps; Description of theproblem, the context and the environment; good understanding of the notion of HIVmainstreaming and its importance as well as resource identification Mainstreaming initiatives had had the impacts that are mentioned below ; Improvedknowledge and behaviour changes among the workers and in the community they serve; Careand support for PLWA improved, reduction of impact of HIV on families and the community,strengthening of civil society organisations and institutional capacity.
The Action Aid and its partners in Ruyigi area included identified the major constraints ofHIV mainstreaming that, Lack of capacity: lack of means to reinforce capacities within the NGOs and associationsdealing with development and humanitarian aidLack of resources: lack of human resources qualified in fighting AIDS, as well as lack ofmaterial and financial resources.
Lack of knowledge of best practices: little transfer of experience and knowledge on howthings are dealt with elsewhereLack of commitment by NGOs: NGOs and CSOs seem not so keen on taking responsibilityfor the medical care of their staff .
Proposed areas of Intervention and collaboration for Oxfam International
and partners in Burundi
There are ten intervention areas that have been identified, in line with the 16 priorityprogrammes described in the National AIDS Strategic Plan 2002-2006 : Programme
Activity areas
Component
Prevention
• IEC campaigns to promote sexula behaviour change among targetted population • Social marketing and distribution of condoms: promote the use of condoms • Promotion of voluntary testing and counseling • Promote pre-nuptial and pre-conception testing, information on means toprevent HIV transmission from parent to child • Psycho-social support : provide staff/personnel with trained counsellors • Improve access to ARV therapy to fight HIV/AIDS: identify strategies to give • Promote links between health / human rights / protection of people with • Income generating activities for the needy: develop a policy giving access toAGR ( ? loans) financing for PLWA • Reinforce the capabilities of national, regional and local associations and NGOs : develop training programmes for partners with a view to enable them tointegrate the struggle against AIDS in their everyday work.
Proposed activities under HIV/AIDS mainstreaming
In the small survey undertaken with OI’s partners, only three of them had started actions to
fight AIDS. The others wanted to start as well, but had constraints with regard to both human
and material resources. The following proposals for action result from a discussion with OI’s
partners on what actions would be taken to start the struggle against AIDS.
1) Integrate the fight against AIDS in day to day life experiences (social-cultural
considerations)
This is what is done in the work place: prevention actions, psycho-social counselling and
ensuring medical treatment.
-
Develop and implement a strategy allowing sick staff to receive medical treatment
Possible partners: ONUSIDA, CNLS, Project GIPA, ANSS
2) Develop a policy to integrate HIV/AIDS
Organise consultative workshops to develop policies on HIV/AIDS in collaboration with
experts on HIV/AIDS.
Possible partners: ONUSIDA, CNLS, UNDP, Project GIPA
3) Mainstream HIV/AIDS impact mitigation in development and humanitarian
programmes
-
Inform and train staff on general aspects of AIDS Reinforce capacities through training and, in order to improve productivity, advocate and promote care and support for PLWA, organization personnel and beneficiaries.
- Integrate prevention activities to beneficiaries of development and humanitarian programs.
Possible partners: ONUSIDA, CNLS, UNDP, Project GIPA, ActionAid
4) Mainstream HIV/AIDS in humanitarian programmes
In order to successfully implement HIV preventive measures in humanitarian programmes,
the programs must be similar to those carried out among satble populations. SWAA-Burundi
has good experience in the subject (activities in displaced people’s camps at the start of the
crisis in the municipality of Bujumbura)
-
Provision of staff in humanitarian programmes with relevant information Integration of IEC seminars on AIDS in all humanitarian programmes Possible collaborators: ONUSIDA, CNLS, Project GIPA, SWAA
Recommendations
A consultative meeting with OI partners in Burundi made the following programmingrecommendations.
• Organise awareness-raising seminars for staff from OI’s partner organisations.
• Organise a workshop to support implementation of staf work place policies with regard to HIV/AIDS and other long term illnesses ? • Organise activities to launch actions to fight AIDS within staff of OXFAM International’s partners on the National AIDS Control day • Identify specific training required by partner organisations which would enable them to integrate the fight against AIDS in their development and humanitarian actions • Identify the available resources and the different methodologies with a view to train trainers in the area of HIV/AIDS for OI’s partners Bibliography
PNLS /MST (National program of fight against AIDS/STD sexually transmitted disease), National epidemiological bulletin for the serological surveillanceHIV/AIDS/STD, 1998 PNLS/MST (National program of fight against AIDS/STD sexually transmitted disease), National epidemiological bulletin for the serological surveillanceHIV/AIDS/STD, July 2001 Un for AIDS/WHO, World epidemic report, 2001 UN for AIDS/WHO, Epidemiological state of the world, December 2002 Study committee of public safety and development “Integration strategies for HIV/AIDS programme in the emergency and development operations: the Ruyigi case”,January 2002 GIPA programme work progress report, December 2002 National study of HIV-AIDS infection extent: final report, December 2002 Social and peculiarities study of HIV-AIDS infection in Burundi, December National programme of fight against AIDS/HIV 2002-2006 Mapping and documentation review of actors engaged in the fight against HIV-AIDS in Burundi / ACTIONAID BURUNDI, October 2001 Institutional analysis of the structures engaged in the fight against HIV-AIDS in Burundi, especially in: Bubanza, rural Bujumbura, Cankuzo, Kayanza, Karuzi,
Kirundo, Makamba, Muramvya, Mwaro, Rutana and Ruyigi.
The following report shows data from a study by IDEC in government ministries on AIDScontrol programming at a departmental level.
Table n°1: Capacity of government ministries in HIV/AIDS programming
Ministry
Existing
Departmen Partnershi
commenceme nal
tal strategy p
and cooperation3. Ministry of domestic affairs and Ministry for Civil Defence4. Ministry of Justice development*.
9. Ministry of the public works and the environment10. Ministry of Finance industry and Ministry ofTourism16. Ministry of public works and x Post Office Board18. Ministry of Energy supply Women’s rights promotionDepartment20. Human rights Department USLCS = Departmental unit for fighting AIDS
(12) The mentioned Departments existed well before the setting of the stop-gap Governmentin November 2001 The following outline presents IDEC study data of the fight against AIDS engaged by localGovernments and public bodies.
Table n°2: Institutional capacity of para-statals and local administrative authorities for
AIDS control
Local authorities and para- Existing
Functional
Departmental
statals agencies
commencement USLCS
strategy
Table 3 : Table listing HIV/AIDS actors at provincial level
DISTRICTS
Diocesan organisation for fighting AIDS;PSI Bubanza (Bubanza Population, Human health and information) ;Turemeshanye Bujumbur
APOPI (HIV and orphans assistance group)PRAUTAO (Food self-sufficiency promotion and orphans support in rural areas)ANSS (National assistance to AIDS-victims)AGBARTSABUBEF (assistance for promoting the family well-being)ADVS (Association for voluntary blood donors)CESA (Federation)IL EST VIVANT A B S (Burundi partnership against AIDS)MENYA-MEDIAFVS (Families against AIDS)CPAJ (Organisation for the support of juvenile association)ASB (Burundi scout Organisation)MESPSAJS (Assistance for justice and solidarity)18.GGBTURWANYE ubukeneNouvelle Espérance (new hope)SRFEJIAMI S F (Women International)FI C (Christian organisation for teachers)SAJOMSRJSIPJSD28.APECOS (Organisation for fighting AIDS)AFOPROCA (Organisation for the development of pieces of work and againstAIDS especially in yards where the need for labour has sharply increased)F U SJ S R. A A DCEPROMETAMS AIDS-victims assistance Organisation SORETO (Organisation for the support and the solidarity of drug addicts)ACSBGIRIMPUHWE Bujumbur
Solidarité pour une meilleure santé et le développement en Afrique (SOSADA-Solidarity organisation for African development and for better health conditions) ;Appui aux orphelins et aux personnes infectées par le VIH (APOPI -HIV andorphans assistance group) Community network for fighting AIDSBururi HospitalCOPED- BururiASVM AIDS-victims supportLes Amis de la Culture (Culture friends)Association « Dufashe abana b’impfuvyi »SWAA Burundi Rutovu networkAnti AIDS unit – BUTUTSI projectAssociation Savoir Plus (Organisations “savoir plus”)Bururi Diocese – Pastoral officePeace and development programme( Bururi)IRC (International rescue committee)-ToraCompréhension Science Conscience COSCO (Science understanding organisation)Organisation for AIDS orphans support ( SIJENAVYIGIZE)Red Cross ( BURURI)Association pour combattre le SIDA ACOS Séminaire de BUTA (Organisation forfighting AIDS – ACOS Buta summit)Programme de la santé reproductive PNSR (Programme for safety reproduction) ACORD (Organisation for fighting AIDS) Cankuzo ;Murore Human Health Committee;Cankuzo CDF (centre for steady family relations) Eglise du plein Evangile (Church)Eglise Episcopale du Burundi (Burundi Episcopal Church)Archidiocèse de Gitega ( BDAG-Promotion santé)/Diocese of Gitega (BDGA-health promotion)Association d’action familiale de Gitega (Family activities network of Gitega)Oxfam G.B. (U.K. Oxfam)Save the childrenAssociation des jeunes pour jeunes contre le SIDA (Juvenile commitment forfighting AIDS)Alliance contre le SIDA/ Gestion Equation Homme/Femme de Gitega (Allianceagainst AIDS/Men’s sector/Women of Gitega)Association Nationale de Soutien aux Séropositifs et Sidéens (National AIDS-HIVvictims support organisation)Association des Fonctionnaires pour le Bonheur familial (Happiness in the bosom ofAIDS-victims families)Urumuri contre le SIDA (Urumuri against AIDS)Association pour encadrement des enfants orphelins (Orphans assistanceorganisation)Association pour l’encadrement des jeunes de Gitega (Organisation for the supportof young people in Gitega)TABARAJeunesse Providence AGAKURA (juvenile Providence)Association de lutte contre le SIDA (Organisation for fighting AIDS)SWAA BurundiREMESHAAppui psychosocial des victime du SIDA (AIDS-victims psychosocial support)Association Nationale de lutte contre le SIDA (ANSS)-antenne Gitega/ANNSNational organisation for fight against AIDS – Gitega networkASS « Twungure ubumenyi mu rugamba rwo kurwanya SIDA) Kayanza :
SWAA / Kayanza network ;Association des Scouts du Burundi (Burundi scout Organisation) /Kayanza network;Réseau inter-confessionnel de lutte contre le SIDA (ROCSI)/Confessional network for fighting AIDS ;Cellule de l’Eglise épiscopale (Episcopal Church unit) ;Kayanza CDF (centre for steady family relations) APECOG war orphans supportGatonde Health authority and medical centre;Equipe de prise en charge des PVVS à Bugenyuzi (AIDS-HIVvictims support organisation in Bugenyuzi) ;Karuzi CDF (centre for steady family relations) Kirundo :
Conseil Norvégien pour les Réfugiés CNR (Refugees NorvegianBoard) ;ANSS – Kirundo Il est vivant (ILEV) – Kirundo IRC (International rescue Committee) / Makamba network ;CORDAID / Makamba network Muramvya SWAA / Muramvya network; Association des PVVS Twizere
(AIDS-HIV victims support organisation in Twizere);Equipe de prise en charge de l’Hôpital Kiganda (Kiganda Hospitalunit) ; Equipe de prise en charge de l’Hôpital Muramvya CroixRouge ( Muramvya Hospital unit, Red Cross) Mbuye network Service Humanitaire aux victimes du SIDA (AIDS-victimshumanitarian service)Association des jeunes de MUYINGA (MUYINGA juvenileassociation)Abaremeshakiyago de GASORWE (GASORWE Abaremeshakiyago)Abaremeshakiyago de RUGARI (RUGARI Abaremeshakiyago )Abaremeshakiyago de la zone BUTARUGERA (BUTARUGERAAREA Abaremeshakiyago )Abaremeshakiyago de MUGANO (MUGANO Abaremeshakiyago )SWAA BURUNDI, MUYINGA networkInternational Medical corps (IMC)Comité Provincial de lutte contre le SIDA (Provincial Committee forfighting AIDS)Twungubumwe Stop SIDA (Twungubumwe Stop AIDS)Burundi Red CrossBureau Diocésain de MUYINGA (MUYINGA Diocesan authority)Local organisation support in fighting AIDS Rusaka women AssociationCheval humanitaire (Humanitarian assistance)AMS AIDS-victims assistance Organisation; 1.Comité provincial de LCS (Provincial Committee for fightingAIDS)2.CC LS MWUMBA3.Cellule comm. Gashikanwa (Gashikanwa unit)4.AASIB5. Kiremba Hospital6.Jeho kuki7.ARESOGI8.PDCLCP9.Ruhororo local unit10.SWAA NGOZI (NGOZI society for Women and AIDS in Africa)11.SWAA Gashikanwa (Gashikanwa society for Women and AIDSin Africa)12.SWAA RUHORORO (RUHURORO society for Women andAIDS in Africa)13.SWAA KIREMBA (KIREMBA society for Women and AIDS inAfrica)14.SWA MWUMBA (MWUMBA society for Women and AIDS inAfrica)15.ABUBEF NGOZI16.Projet CARE17.AFN18.AFAVO19.CDF Gashikanwa (Gashinkanwa centre for steady familyrelations)20.CDF MWUMBA (MWUMBA centre for steady family relations)21.CDF NGOZI ( NGOZI centre for steady family relations) Actionaid / RutanaInternational Medical Corps (IMC) ;CDF Rutana (Rutana centre for steady family relations) ;SPSVS (Organisation for AIDS_victims support and for prevention) Actionaid / Ruyigi ;Maison SHALOM (Shalom house)SWAA (society for Women and AIDS in Africa) / Ruyigi ;BDDR (Diocesan development Office in Ruyigi) ;AFPEOD (Women Organisation for have-not and orphans rescue);UNISIP (Union for fighting AIDS and poverty);CDF (centre for steady family relations) / Ruyigi.
Cost of antiretro viral drugs in Burundi
I.
TARGETED THERAPIES AND DRUGS
PRODUCTS
PRICE IN FBU (Burundi francs)
COMBIVIR
CP 300MG + 150MG
: 51.460 FBU
CRIXIVAN
: 43.200 FBU
: 16.540 FBU
RETROVIR
: 35 400 FBU
: 36.650 FBU
: 22 860 FBU
: 16 550 FBU
: 3 750 FBU
: 3 160 FBU
ABACAVIR*
: 81.250 FBU
* This product did not benefit by any cut in its price
Triple combination therapy costs on average 100 000 FBU (Burindi francs) and peaks
from 42 560 to 160 850 FBU according to the different drug combinations.
GENERIC DRUGS
PRODUCTS PRICES
Duovir CP 300MG + 150MG (COMBIVIR)
Duovir N Cp CP 300MG + 150MG+ 200 MG (AZT+Epivir+Névirapine)
Efavir CP 200 MG (EFAVIRENZ)
Lamivir CP150 MG (EPIVIR)
Lamivir S CP150 MG (EPIVIR+ZERIT)
Nevimune CP 200 MG (NEVIRAPINE)
Stavir CP 40 MG
Stavir CP 30 MG
Zidovir tablets CP 300 MG
Triple drug therapy costs on average 46 250 FBU and peaks from 30 800 to 67 700 FBU
(Burundi francs) according to the different drug-combinations.

Source: http://www.oxfam.org/sites/www.oxfam.org/files/burundi.pdf