The first AIDS case in Burundi was diagnosed in 1983. Since then the epidemic has grown rapidly, making HIV and AIDS one of the major causes of mortality in the country. The socio-political crisis of the 1990s, poverty and large-scale displacement of populations have contributed to the rapid spread of the epidemic which is generalised . Burundi recently emerged from a prolonged civil war that devastated much of its economy, infrastructures and social services. The 1993–2005 conflict had a profound impact on the living conditions of the population, significantly increasing vulnerability to poverty, violence, food insecurity and disease, including HIV/AIDS. The continued political conflict in Burundi was exacerbated by the assassination of the country’s first president in 1993 and his successor in 1994 which plunged the country into civil war . During the time of war it was civil society organisations like the Society of Women and AIDS in Africa (SWAA), Association Nationale de Soutien aux Seropositifs et Sideens (ANSS) etc which were supporting community initiatives on HIV and AIDS related activities.
The country has a population of 8.5 million with 52% of people under the age of 18. The epidemic in Burundi is classed at ‘generalised’ with a prevalence of 3.6%. However recent evidence shows discrepancies in prevalence between rural and urban communities and also between men and women. The emergence of at risk populations such as men who have sex with men, long distance lorry drivers and commercial sex workers demonstrates the need for a national HIV/AIDS strategy that considers these key populations.
Although civil society organisations continued to shoulder most of the AIDS’ work, the war crisis persisted in hindering the fight against HIV and AIDS. In 2002, the government established the Council for the Fight against AIDS (CNLS) to coordinate and guarantee a multi-sectoral coordination of HIV and AIDS work now under the Ministry of HIV and AIDS. CNLS was established to manage the World Bank project - the Muti-Country HIV and AIDS Programme (MAP) which promoted a multi-sectoral response to HIV and AIDS aimed at engaging both local communities and the private sector.