Burundi : the fight against AIDS on the verge of a historic setback

SOS Médias Burundi

Bujumbura, December 1, 2025 — After two decades of significant progress, the fight against HIV/AIDS in Burundi is entering a critical phase. Encouraging figures demonstrate the effectiveness of testing and treatment programs, but a sharp reduction in international funding is now jeopardizing these gains. A “silent crisis” that could reverse the trend, warn those working in the sector.

A doctor who worked in a specialized care unit in Bujumbura is clear : “Burundi had met and even exceeded several international targets, but the momentum is faltering. We are now operating in survival mode.”

Solid results… but fragile

The most recent estimates put the number of people living with HIV in the country at between 79,000 and 81,250. In 2023, approximately 1,200 new infections were recorded, while 1,600 people died from AIDS.

The prevalence among 15–49 year olds remains relatively low (0.9%), but it is still higher among women (1.2%) than among men (0.6%). These indicators reflect the positive impact of prevention, testing, and antiretroviral treatment campaigns.

According to the expert interviewed, Burundi had reached the global 90-90-90 targets and is approaching the 95-95-95 threshold :

94% of people living with HIV know their status,

93% are on antiretroviral treatment,

87% have an undetectable viral load.

A worrying turning point : declining funding

But a major risk casts a shadow over the future. Since 2025, the decrease in contributions from international partners—particularly the reduction in support from PEPFAR (the United States President’s Emergency Plan launched in 2003 to support the fight against AIDS)—has profoundly affected access to essential services. Several facilities are operating with minimal supplies, some on the verge of running out.

Mother-to-child transmission : a persistent Achilles’ heel

The most pressing challenge remains mother-to-child transmission, estimated at 15.6% in 2023, more than three times the target level of less than 5%.

This gap highlights the difficulties in prenatal screening, support for HIV-positive women, and postnatal care.

Young people on the front lines

Among the particularly vulnerable groups are young people aged 15 to 23, in whom the prevalence is significantly higher than the national average. A wake-up call, according to the doctor, who calls for strengthening targeted prevention programs, access to health centers, and sex education adapted to current realities.

A global challenge that transcends borders

According to UNAIDS, 40.8 million people were living with HIV in 2024, with 1.3 million new infections and 630,000 deaths recorded worldwide that same year. Burundi’s efforts are therefore part of a global dynamic where every local setback represents a risk of international conflagration.

Burundi has demonstrated that it can make progress when resources are available. But without sustainable resources, the country could lose what it has taken twenty years to build. Stable funding, strengthening the health system, and protecting vulnerable populations—especially young people—will be crucial to preventing a return to the past.