Françoise:
I am Francoise Ndayishimiye, I come from Burundi and I am a medical doctor. I have been involved in the fight against AIDS for 13 years now. I began when I was still in the Faculty of Medicine, but got more involved as I worked with associations around the country. I became much more involved when I learned that I was HIV positive. Knowing my status motivated me even more to fight against this disease and sensitize others to avoid it. My greatest fight has especially been for all patients to access free treatment.

Because of funding received from donors, especially the Global Fund to fight AIDS Tuberculosis and Malaria, we have been able to put this policy of access to treatment for all into practice.

Robert:
How many people are accessing this free treatment?

Françoise:
Currently we have 7500 people, but in 2002, we had only 600 people under treatment, and these were not even well monitored because they came for treatment intermittently- that is, when they had money, and stopped when they did not, and sometimes began again.

Robert:
As a doctor, I would imagine that each day you meet many people who are alive today because of the medicines which have now been made available?

Françoise:
Yes, I could give an example of a relative who was under inadequate treatment because she did not have enough money to buy medicines. Now she receives adequate treatment because it is widely acceptable. She was, for those who know her, in the final stages of life, but now she has been able to go back to work despite the disease. When I see her it gives me hope and courage to continue the fight.

Robert:
Is this person close to you or your family?

Françoise:
Yes, she is my mother. She is a woman I deeply adore, who did all she could to take care of us even after my father passed away. And besides being a grandmother, she took care not only of her children but also those of her sisters who died during the war. This would probably have been too much for her to bear, but the money from the Global Fund has enabled her to take better care of herself.

Q. That is definitely a story which affected you directly; it doesn’t get much closer than a mother. Have you come across many similar stories?

Françoise:
Yes, there are so many stories, I don’t know if I could recount them all. There are stories about children who have been saved; children whom people thought would not live longer than two years. Now they are fifteen years old! They probably made it from two to 10 years without treatment, and were lucky to have received help just when they were beginning to have problems with schooling. Before, they could not go to school but now they are growing in school as adolescents and soon they will be called upon, as mothers and fathers, to develop the country. I think treatment impacts not only the lives of individuals but also those of the communities in which they live, because it enables communities to live normally and productive populations who can develop their countries.

Part 2

Q. Could you please give me an idea of the impact of AIDS in a small country like Burundi?

Françoise :
Burundi, as you say, is a small country in Central Africa, sometimes classified as part of Eastern Africa. It has a population of 7 million. It has been highly affected by AIDS and is also politically unstable. Above all, it is a poor country, where nobody earns enough to afford a month’s worth of ARV treatment. This is why people living with HIV/AIDS have been fighting for access to free ARVs and for the free treatment of opportunistic infections.

Finally, we have a good treatment policy with 7500 patients accessing treatment. I think this has had a really positive effect on the lives of people living with AIDS. It is true that in Burundi HIV/AIDS was becoming less of a taboo, and that people addressed it more freely. Still, today it is much better because people are more hopeful. I am sure that I can live for a long time. These days I am not afraid of letting a patient know when they are HIV positive because there are drugs I can prescribe for them. Before 2000, it was really disturbing to tell a patient, ‘Sorry, you are HIV positive, you have the virus, you will be able to continue living normally, please try to eat well, but the medicines are still too expensive- we will see in future if their prices decrease.’ These days, we have clear prescriptions for those who test HIV positive.

Q. So, within communities what are the signs that results are being achieved?

Françoise :
The onset of free treatment in Burundi has changed much within communities. To begin with, people are no longer afraid of going for testing, which also enhances prevention efforts. When someone learns about their status, whether positive or negative, that changes a lot of things within the community. The acceptance of people living with AIDS has also increased because of treatment, since people who were at an advanced stage can now re-embark and have normal lives. Currently, AIDS is discussed more freely within families and during meetings.

Q. You are also a member of the Global Fund’s board. What does the Global Fund represent, in your view?

Françoise:
I am happy to be represented in the Global Fund board as a person living with HIV/ AIDS, because I get to have a voice. When I vote, my voice is equal to that of the United States of America. That is something that I have hardly seen before! That if I manage to argue my case well, my point of view will even outweigh that of the United States – that is a big thing and it began with the Global Fund; I had never seen it elsewhere, which is what I keep repeating. However, today, a number of organizations are beginning to debate ways to reorganize their administrative boards. We who live with AIDS know what it means. We also have professionals among us. We also have something to say- we can add value! I think the Global Fund gave us the opportunity to add our views to the decisions that are made at the board level regarding us. If these decisions are made without our input, they may end up working against us.

Q. 7'500 people: that does not represent the total population living with AIDS or those in need of assistance in Burundi, does it?

Françoise:
No, that does not represent the total number of people in need of assistance. According to the latest national statistics, there were about 25000 people in need of treatment, and the country had planned to treat 12500, but resource mobilization has been slow. Actually, only the Global Fund offered to provide free treatment. Part of this project is to be financed by the World Bank.