The director of Service Yezu Mwiza (SYM), an AIDS project run by the Jesuits in Burundi, has urged UNAIDS and other partners to step up advocacy for universal access to treatment and for better management of the Global Fund, so that services will be more easily available to those who need them.
Fr Désiré Yamuremye SJ was addressing UNAIDS chief Michel Sidibé on behalf of civil society representatives during a meeting in Bujumbura on 9 May. Civil society organisations, including SYM, run 51 out of 132 sites offering treatment and care to people with HIV in Burundi. They reach more than 15,000 people – more than half the total number on antiretroviral treatment (ART) in the country.
Fr Désiré thanked Sidibé for his visit and commitment to help Burundi, which is one of 22 priority countries in a UNAIDS campaign to end mother-to-child transmission of HIV. However, the SYM director said that while efforts of the international community to fight AIDS were “highly appreciable and appreciated”, they remained inadequate and tended to be shorter rather than longer term.
He also urged the government of Burundi to mobilise more resources to diversify funding sources for the national AIDS response, which is currently dependent on the Global Fund to fight AIDS, TB and Malaria, and said public health authorities had so far failed to live up to their pledges to guarantee universal access to comprehensive care and treatment.
A representative of people with HIV addressed Sidibé a day earlier, during a well-attended event in Kamenge to mark Burundi’s National AIDS Day. He appealed to UNAIDS to “keep the promise” – the UN agency’s slogan – and echoed the call for better management of services, to ensure that people with HIV do not fall victim to misunderstandings between project implementers and decision-makers.
The other recommendations of people with HIV were: that they be actively involved in the planning and implementation of services intended for them; that they receive food support and free medical care; and that third-line ARVs be available for those who are resistant to second-line treatment.
Both the representative and the SYM director had a word of thanks for the government’s efforts to scale up access to ART and prevention of mother-to-child transmission of HIV (PMTCT). During the 8 May event, the Minister for Health, Dr Sabine Ntakarutimana, outlined the progress made: from just over 8,000 people on ART in 2006 to 29,500 in 2013.
But Fr Désiré said this was still not enough: “It is regrettable to see that universal access to care and ART is not yet a reality. The efforts made by our government to put in place policies and promises have not been followed by palpable facts. The absence of holistic quality care in some public structures means that people with HIV turn to associations and faith-based organisations as a last resort.”
Referring to the Burundian government’s pledge to allocate 15% of its budget to healthcare, as a signatory of the 2001 Abuja Declaration, Fr Désiré said this had yet to happen, adding: “Efforts to strengthen the health system and to scale up access to ARVs remain inadequate for a proper response.”
Moving away from the health response, Fr Désiré drew attention to the stigma and discrimination that unhappily persist against people with HIV. “The rights of widows and orphans are trampled,” he said. “The law of our country is not at all clear regarding the protection of these vulnerable people, who are rendered even more so because of dispossession and other social injustices they must endure.”