With 10.1 inhabitants and an HIV prevalence of 3.5% in the adult population, Chad has an estimated 180,000 people infected by HIV/Aids. This epidemic is characterised by a strong prevalence in certain geographical zones, in particular N´Djamena (7% prevalence in 2005) and in the region of Western Logone, around Moundou (6.5% in 2005). Overall, prevalence is three times higher in urban zones (7%) than in rural zones (2.3%). These data indicate that Chad is a country with a generalized epidemic. Chad is one of the countries the most affected by HIV/Aids in Central Africa.

Beginning in 2004 and thanks to aid from the Global Fund and mobilisation by medical circles, HIV care, treatment and support was marked by a strong political commitment in favour of the fight against HIV. Following a decree at the end of April 2007, ARV therapy, medicines for opportunistic infections, initial work-ups and monitoring became free owing to Chadian government financing with the support of UNITAID for second-line ARV therapy. Today, the country has 22 HIV care and treatment sites including 5 PMTCT sites. At the end of 2008, 14,000 people including 67 children were benefitting from tritherapy and regular monitoring in Chad.

The PNLS, dependent on the DGAS of the Ministry of Public Health, is currently the essential actor in the organization and implementation of activities in the fight against Aids. A project to directly link PNLS to the Prime Minister's office (in the form of a National Committee to Fight Aids) is being implemented. After several rejections, the Global Fund accepted Chad's Round 8 proposal in October 2008. Chadian civil society is beginning to organize and is currently a major presence in the care and treatment system.

In 2007, the Chadian Ministry of Health began to collaborate with the AFD and GIP ESTHER. This has led to a support project to fight Aids for the next 3 years with ESTHER management. This collaboration will begin in the field in 2009.