• Improved access to and use of testing and treatment services – 28 VCT centres were equipped with testing kits and personnel. 43,067 people were tested for HIV/AIDS, and 681 adults received ARV treatments and 73 pregnant HIV-positive women enrolled in a prevention of mother-to-child transmission (PMTCT) programme.
• Improved economic wellbeing – Income-generating activities (IGAs) improved the wellbeing of at least 25,000 community members. By involving community members in producing food for their own consumption and for resale, this Initiative has reignited the sense of pride lost through years of dependence on aid and relief donations by well-meaning charitable organisations.
• Education and vocational training – 10,858 orphans and vulnerable children stayed in school thanks to the provision of school fees, uniforms and books. Also, 284 people, mostly youth, were trained in skills such as cooking, catering and carpentry.
• Equipment for ARV treatment – Rutana Province was provided with a CD4+ T cell count machine – one of only four in the entire country. The machine enables doctors to determine patients’ viral loads and prescribe the appropriate ARV treatment.

Rural populations in Burundi suffer from poor access to quality health care and prevention services, as a high proportion of government health funds are allocated to urban hospitals. This results in much fewer and poorer quality health care facilities in rural areas, leading to poor health outcomes. HIV/AIDS, in particular, is a leading cause of death in Burundi and rural areas like Rutana Province have been most impacted by the disease. In a conflict-affected area with high poverty rates like Rutana, HIV/AIDS takes an even greater economic toll on individuals who suffer from the virus, impacting their ability to provide for themselves and their families. Prior to this Initiative, Rutana Province had no governmental or NGO HIV/AIDS-focussed programmes despite its high poverty levels and HIV prevalence rates of 7.3 percent – compared to the national rate of 2.3 percent. In fact, only three health centres, aside from the provincial hospital, were equipped to provide HIV voluntary counselling and testing (VCT) services to Rutana's nearly 300,000 residents. Further barriers to HIV/AIDS prevention included facilities' lack of testing kits and distance to testing centres. Stigmatisation was also a serious barrier for testing, education, and treatment.

In 2007, the Burundi HIV/AIDS Initiative was created to provide prevention education, improve access to VCT services, provide antiretroviral (ARV) drugs for those infected with HIV/AIDS, and engage community members in income-generating activities (IGAs) to improve their wellbeing and also reduce stigma for people living with HIV/AIDS (PLHA). Ten Burundian organisations were selected to run these programmes and deliver the Initiative’s goals. The Initiative aimed to prevent new HIV cases by providing HIV/AIDS education and sensitisation and increasing access to testing and counselling services. Providing accurate information on the disease and how it is transmitted plays a major role in successful stigma reduction. By providing access to ARV drugs and creating opportunities for HIV-positive people to engage in agricultural IGAs through their support groups, the Initiative aimed to help people living with the disease to positively manage its impact on their families and communities. A farming-collective approach was designed to build social cohesion through group associations that work together in large-scale farming projects. Members of these associations and support groups for PLHA also provide social, emotional, and even financial support for one another. Finally, the Initiative targeted orphans and vulnerable children who had been impacted by HIV/AIDS or years of conflict, providing them with educational support and vocational skills training. With an investment of US $1,489,927, this Initiative was designed to impact a total of 67,618 beneficiaries.

At the onset of this Initiative, HIV/AIDS in Rutana Province and in most of Burundi was a taboo subject that required careful language to communicate how it is transmitted. After three years of continuous education and sensitisation, however, discussions of HIV/AIDS are no longer taboo. The provision of ARVs to infected persons has resulted in a reduction in the number of children being orphaned in the province, compared to three years ago, when VCT services were unavailable and ARV treatments were inaccessible. The 28 VCT centres that were equipped through this Initiative will continue to provide services to community members. Pregnant women, if HIV-positive, will have the opportunity to receive ARVs to prevent transmission of the virus to their unborn children. This is an opportunity for Burundi to stem the tide of new infections going forward, particularly among newborns and infants.
 
The Initiative’s presence changed the development landscape of Rutana Province by attracting other NGOs and INGOs to establish programmes in the province. Most of these organisations expressed tremendous support and admiration for the our grant manager’s Strategic Initiative model, due to its enabling of various organisations to work in different districts without duplicating efforts or overlapping interventions.

In 2009, Rutana’s governor presented this Initiative to the government, which resulted in it being lauded as a replicable community development model that could be used across the country. It not only achieved its goals regarding HIV/AIDS, but it also succeeded in creating employment, boosting food production, and improving the region’s agricultural economy through the production of pineapples and rice that were sold in markets beyond the province.

Improved coordination among implementers could have resulted in better care of beneficiaries, better delivery of services and even a reduction of turnover of health personnel.