Chad: Score Justification Summary

1.1.1a National plan for AMR priority pathogens

Score: 100

There is evidence of an AMR plan covering surveillance, detection and reporting in Chad. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Antimicrobial Resistance” section that Chad “developed and adopted a National Multisectoral Action Plan for the Fight Against Antimicrobial Resistance (NAP AMR)” (p. 16). ¹ The 2018 “(National Multisectoral Action Plan for the Fight Against Antimicrobial Resistance (Plan National Strategique De La Lutte Contre L’antibioresistance — AMR)” includes objectives relating to surveillance, detection and reporting. Chapter III of the plan lays out the 5 “strategic axes”: Axis 1 covers raising awareness of AMR among both the population at large and of key stakeholders; Axis 2 covers “Implement monitoring and research on Antibiotic Resistance”, which includes “Establish a national AMR surveillance system”, “Strengthen laboratory capacities for AMR surveillance in key sectors”, and “Implement operational research projects aimed at deepening knowledge on AMR and the use of antimicrobial agents in the food and agriculture sector, including transfers from or to humans and the context of agricultural and food production”; axis 3 covers “Reduce the incidence of infections through effective prevention measures (hygiene, vaccination) in the human and animal health sectors”; axis 4 covers “Improving the use of antimicrobial drugs in human, animal, and plant health” and axis 5 covers “Strengthening the regulatory framework for combating antibiotic resistance” (pp. 24-25). ²

1.1.1b Capacity of national lab/lab system to test for AMR priority pathogens

Score: 0

There is insufficient evidence of a national laboratory/laboratory system which tests for priority AMR pathogens in Chad. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” recommends in the “Antimicrobial Resistance” section for “The creation of a national reference laboratory for antimicrobial resistance (AMR)” (p. 18). ³ The 2018 “(National Multisectoral Action Plan for the Fight Against Antimicrobial Resistance (Plan National Strategique De La Lutte Contre L’antibioresistance — AMR)” reports that “At the national level, there is no quality control and reference laboratory for detecting and reporting pathogens (surveillance of antimicrobial-resistant bacteria). Nor is there a body responsible for coordinating and facilitating collaboration between the various sectors involved in combating AMR, which would be tasked with developing and implementing standardized procedures” (pp. 14). ⁴ The website of the National Reference University Hospital Center (Centre Hospitalier Universitaire the National Reference — CHU-RN) does not contain evidence of the ability to test for priority AMR pathogens. ⁵

1.1.1c National environmental surveillance for AMR residues/organisms

Score: 0

There is insufficient evidence that Chad conducts environmental detection or surveillance activities (e.g., in soil, waterways) for antimicrobial residues or AMR organisms. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Antimicrobial Resistance” section of “The existence of seven (7) sentinel sites providing data on antimicrobial resistance” and laboratories capable of testing wastewater but notes that “data collection is not always based on a standard approach and suffers from deficiencies in national coordination and/or quality management” (p. 17). The JEE does not contain specific evidence of environmental surveillance activities. ⁶ The 2018 “(National Multisectoral Action Plan for the Fight Against Antimicrobial Resistance (Plan National Strategique De La Lutte Contre L’antibioresistance — AMR)” includes the objective of “Establish a national AMR surveillance system” (p. 24) but does not state that the system will include environmental surveillance. ⁷ There is no information concerning environmental detection or surveillance activities for AMR residue or organisms on the websites of the Ministry of Public Health and National Solidarity ⁸, the Ministry of Livestock and Animal Husbandry ⁹, the Ministry of the Environment and Fisheries ¹⁰ or the Ministry of Higher Education, Research, and Innovation ¹¹. The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were inaccessible at the time of research.

1.1.2a National law(s) requiring prescription for antibiotic use (humans)

Score: 50

There is publicly available evidence that Chad has national legislation or regulation in place requiring prescriptions for antibiotic use for humans; however, there is evidence of gaps in enforcement. The 2017 “Joint External Evaluation of IHR Core Capacities of the Republic of Chad: Mission report 7-11 August 2017”, reports in the “Antimicrobial Resistance” section that “A prescription is required in all pharmacies for antibiotics in humans and in animals” (p. 12). ¹² Although it is not explicitly expressed in the law N°024/PR/2000, related to the Pharmacy, there is an implicit reference that Chad requires prescriptions for antibiotics for humans, since, according to article 135, those who have received substances classified as narcotics with a fake prescription will be sanctioned. ¹³ The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” includes recommendations for “The establishment of a mechanism to identify substandard products;” and “Strengthening the enforcement of penalties for counterfeit or substandard products.” (p. 19). ¹⁴

1.1.2b National law(s) requiring prescription for antibiotic use (animals)

Score: 50

There is publicly available evidence that Chad has national legislation or regulation in place requiring prescriptions for antibiotic use for animals; however, there is evidence of gaps in enforcement. The 2017 “Joint External Evaluation of IHR Core Capacities of the Republic of Chad: Mission report 7-11 August 2017”, reports in the “Antimicrobial Resistance” section that “A prescription is required in all pharmacies for antibiotics in humans and in animals” (p. 12). ¹⁵ Although it is not explicitly expressed in the law N°024/PR/2000, related to the Pharmacy, there is an implicit reference that Chad requires prescriptions for antibiotics for humans, since, according to article 135, those who have received substances classified as narcotics with a fake prescription will be sanctioned. ¹⁶ The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” notes “There is no national policy or legislation regarding the quality, safety and efficacy of antimicrobials and antimicrobial pesticides and their distribution, sale and use in other sectors” (p. 19) and includes recommendations for “The establishment of a mechanism to identify substandard products;” and “Strengthening the enforcement of penalties for counterfeit or substandard products.” (p. 19). ¹⁷

1.2.1a Laws/plans on zoonotic disease

Score: 0

There is evidence that Chad has plans or strategy documents for zoonotic disease prioritization, detection and reporting, but those documents are not public. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Zoonosis” section that Chad “has developed a documented multisectoral national policy and strategy and/or plan for responding to zoonotic events” (p. 21). ¹⁸ However, that plan is not publicly available, including on the websites of the Ministry of Public Health and National Solidarity ¹⁹, the Ministry of Livestock and Animal Husbandry ²⁰, the Ministry of the Environment and Fisheries ²¹, or the Ministry of Higher Education, Research, and Innovation ²². The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unavailable at the time of research.

1.2.1b Laws/plans on zoonotic disease spillover from animals to humans

Score: 100

There is evidence of national legislation, plans or equivalent strategy document(s) in Chad which include measures for risk identification and reduction for zoonotic disease spillover events from animals to humans. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Zoonosis” section that Chad “has developed a documented multisectoral national policy and strategy and/or plan for responding to zoonotic events” (p. 21). ²³ However, that plan is not publicly available, including on the websites of the Ministry of Public Health and National Solidarity ²⁴, the Ministry of Livestock and Animal Husbandry ²⁵, the Ministry of the Environment and Fisheries ²⁶ or the Ministry of Higher Education, Research, and Innovation ²⁷. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unavailable at the time of research.) The

1.2.1c Laws/plans for surveillance & control of multiple zoonotic pathogens

Score: 100

There is evidence that Chad conducts surveillance of zoonotic disease in wildlife (e.g., wild animals, insects, other disease vectors), poultry, and livestock. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Zoonosis” section that in Chad, “The animal health, public health, and environmental sectors have adopted a list of priority zoonoses” and confirms “The effective functioning of the zoonosis epidemiological surveillance network,” “The existence of a regulatory framework for the management of zoonoses,” “The existence of a surveillance system for animal populations affected by priority zoonoses” and “The existence of a surveillance system for priority zoonotic diseases in humans” (p. 21). ²⁸ However, that plan covering zoonotic surveillance is not publicly available, including on the websites of the Ministry of Public Health and National Solidarity ²⁹, the Ministry of Livestock and Animal Husbandry ³⁰, the Ministry of the Environment and Fisheries ³¹ or the Ministry of Higher Education, Research, and Innovation ³². The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unavailable at the time of research.

1.2.1d Cross-ministerial department/agency/unit for zoonotic disease

Score: 0

There is insufficient evidence of a department, agency, or similar unit functioning as a multi-sectoral co-ordinating mechanism dedicated to zoonotic disease that functions across ministries in Chad. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Zoonoses” section that “Coordination of surveillance activities between the animal health, public health, and environmental sectors is informal and limited to a few diseases. Information sharing is not systematic” (p. 21). ³³ There is no evidence of such an organization on the websites of the Ministry of Public Health and National Solidarity ³⁴, the Ministry of Livestock and Animal Husbandry ³⁵, the Ministry of the Environment and Fisheries ³⁶ or the Ministry of Higher Education, Research, and Innovation ³⁷. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

1.2.1e Presence of One Health strategic plan

Score: 0

There is no evidence of Chad having a One Health Strategic Plan in place. ³⁸ However, the government has established the “One Health” platform in November 2022, but its operationalization has been slow. ³⁹ There is no plan but there is evidence that local project teams have prepared a draft plan to guide the elaboration of a national One Health strategy. ⁴⁰

1.2.2a Surveillance/reporting mechanism for zoonotic disease for livestock owners

Score: 0

There is insufficient evidence of a national mechanism for owners of livestock to conduct and report on disease surveillance to a central government agency in Chad. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Zoonoses” section that Chad has a zoonosis surveillance network but it does not contain evidence of a central government agency or that individual owners of livestock can conduct or report surveillance activities. (p. 21). ⁴¹ The 2019 PVS Evaluation Follow-up Report did not contain evidence of such a system. ⁴² There is no evidence of such a system on the websites of the Ministry of Public Health and National Solidarity ⁴³, the Ministry of Livestock and Animal Husbandry ⁴⁴, the Ministry of the Environment and Fisheries ⁴⁵ or the Ministry of Higher Education, Research, and Innovation ⁴⁶. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

1.2.2b Laws/regulations on data confidentiality to protect livestock owners

Score: 0

There is limited publicly available evidence that Chad has laws or guidelines that explicitly safeguard the confidentiality of identifiable health information for individuals, such as that generated through health surveillance activitie. Act No. 007/PR/2015 of February 10, 2015, on Personal Data protection (‘The Act’) (Loi N°007/PR/2015 portant Protection des Données à Caractère Personnel. Voir La Loi N°007) includes specific provisions safeguarding health information, however it is not explicitly cover when reporting animal disease surveillance data. Article 16 of the law defines “Special categories of data” and prohibits their processing without consent or in limited circumstances: “The processing of biometric data and personal data which, if processed for what they reveal or contain, reveal racial or ethnic origin, parentage, political opinions, religious or philosophical beliefs, trade union membership, sex, as well as the processing of data concerning health and sex life is prohibited unless: a) the data subject has given their explicit written consent, whether on paper, electronically, or any other equivalent medium, to such processing, except where the law provides that the prohibition referred to in paragraph 1 cannot be lifted by the data subject's written consent;”. ⁴⁷ Further data that is collected is subject to strict safeguards. Article 59 covers data security: “The processing of personal data is confidential. It is carried out exclusively by persons acting under the authority of the data controller or their subcontractor and only on their instructions. For the processing of personal data, the data controller or their subcontractor must choose persons who, with regard to preserving data confidentiality, provide all the necessary guarantees of technical and legal knowledge and personal integrity. A written undertaking to comply with this law must be signed by the persons processing such data” Article 61 covers security obligations: “The controller and/or its processor are required to implement appropriate technical and organizational measures to protect personal data, in particular to prevent them from being distorted, damaged, or accessed by unauthorized third parties. In particular, it shall take all measures aimed at: a) ensuring that, when using an automated data processing system, authorized persons may only access personal data within their competence; b) ensuring that the identity of third parties to whom personal data may be transmitted can be verified and established; c) ensuring that the identity of the persons who have had access to the information system and what data have been read or entered into the system, at what time, and by which person can be verified and established retrospectively; d) preventing any unauthorized person from accessing the premises and equipment used for data processing; e) preventing data carriers from being read, copied, modified, destroyed, or moved by an unauthorized person;”. ⁴⁸

1.2.2c Wildlife zoonotic disease surveillance

Score: 100

There is evidence that Chad conducts surveillance of zoonotic disease in wildlife (e.g., wild animals, insects, other disease vectors), poultry, and livestock. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Zoonosis” section that in Chad, “The animal health, public health, and environmental sectors have adopted a list of priority zoonoses” and confirms “The effective functioning of the zoonosis epidemiological surveillance network,” “The existence of a regulatory framework for the management of zoonoses,” “The existence of a surveillance system for animal populations affected by priority zoonoses” and “The existence of a surveillance system for priority zoonotic diseases in humans” (p. 21). ⁴⁹ However, that plan covering zoonotic surveillance is not publicly available, including on the websites of the Ministry of Public Health and National Solidarity ⁵⁰, the Ministry of Livestock and Animal Husbandry ⁵¹, the Ministry of the Environment and Fisheries ⁵² or the Ministry of Higher Education, Research, and Innovation ⁵³. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

1.2.3a Annual reporting to OIE on zoonotic disease incidence

Score: 100

There is publicly available evidence of a mechanism for reporting notifiable diseases to the World Organisation for Animal Health (WOAH) in Chad. The World Organization for Animal Health includes a list of Animal Disease Notification Focal Points on its website, who are responsible for transmitting information concerning notifiable diseases for inclusion in the WAHIS database; Chad has an Animal Disease Notification Focal Point, the Head of Animal Disease Surveillance, Directorate General of Veterinary Services. ⁵⁴

1.2.4a Number of veterinarians per 100,000 people

Score: 2.42

1.2.4b Number of veterinary para-professionals per 100,000 people

Score: 4.37

1.2.5a Inclusion of private sector in national plan/law on zoonotic disease

Score: 0

There is insufficient evidence that the national plan on zoonotic disease or other legislation, regulations, or plans include mechanisms for working with the private sector in controlling or responding to zoonoses in Chad. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Zoonosis” section that in Chad, “The animal health, public health, and environmental sectors have adopted a list of priority zoonoses” and confirms “The effective functioning of the zoonosis epidemiological surveillance network,” “The existence of a regulatory framework for the management of zoonoses,” “The existence of a surveillance system for animal populations affected by priority zoonoses” and “The existence of a surveillance system for priority zoonotic diseases in humans” (p. 21); however, the JEE makes no mention of working with the private sector. ⁵⁵ However, that plan covering zoonotic surveillance is not publicly available, including on the websites of the Ministry of Public Health and National Solidarity ⁵⁶, the Ministry of Livestock and Animal Husbandry ⁵⁷, the Ministry of the Environment and Fisheries ⁵⁸ or the Ministry of Higher Education, Research, and Innovation ⁵⁹. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.) Chad does have a WOAH focal point. ⁶⁰

1.3.1a Updated national records of especially dangerous pathogen/toxin inventories

Score: 0

There is insufficient evidence that Chad has in place a record, updated within the past five years, of the facilities in which especially dangerous pathogens and toxins are stored or processed, including details on inventories and inventory management systems of those facilities. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Biological Safety and Security” section that Chad “does not yet have legislation on biosafety and biosecurity”, “No national strategy for waste management or the transport of biological samples has been implemented”, and “No inventory of pathogens has been conducted within facilities that store or handle these dangerous agents and toxins” (p. 26). ⁶¹ There is no evidence of a record of the facilities in which especially dangerous pathogens and toxins are stored or processed on the websites of the Ministry of Public Health and National Solidarity ⁶², the Ministry of Livestock and Animal Husbandry ⁶³, the Ministry of the Environment and Fisheries ⁶⁴ or the Ministry of Higher Education, Research, and Innovation ⁶⁵. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.) Chad has not submitted confidence building measures under the BWC. ⁶⁶ There is no evidence of such a report in the Verification Research, Training and Information Centre (VERTIC) database. ⁶⁷

1.3.1b Biosecurity laws on facility security for especially dangerous pathogens

Score: 0

There is insufficient evidence that Chad has in place legislation and/or regulations related to biosecurity which address requirements such as physical containment, operation practices, failure reporting systems, and/or cybersecurity of facilities in which especially dangerous pathogens and toxins are stored or processed. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Biological Safety and Security” section that Chad “does not yet have legislation on biosafety and biosecurity”, “No national strategy for waste management or the transport of biological samples has been implemented”, and “No inventory of pathogens has been conducted within facilities that store or handle these dangerous agents and toxins” (p. 26). ⁶⁸ There is no evidence of such legislation and/or regulations on the websites of the Ministry of Public Health and National Solidarity ⁶⁹, the Ministry of Livestock and Animal Husbandry ⁷⁰, the Ministry of the Environment and Fisheries ⁷¹ or the Ministry of Higher Education, Research, and Innovation ⁷². (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.) Chad has not submitted confidence building measures under the BWC. ⁷³ There is no evidence of such legislation and/or regulations in the Verification Research, Training and Information Centre (VERTIC) database. ⁷⁴

1.3.1c Agency for enforcement of biosecurity laws/regulations

Score: 0

There is insufficient evidence that Chad has in place legislation and/or regulations related to biosecurity that establish an agency responsible for the enforcement of biosecurity legislation and regulations. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Biological Safety and Security” section that Chad “does not yet have legislation on biosafety and biosecurity”, “No national strategy for waste management or the transport of biological samples has been implemented”, and “No inventory of pathogens has been conducted within facilities that store or handle these dangerous agents and toxins” (p. 26). ⁷⁵ There is no evidence of such legislation and/or regulations on the websites of the Ministry of Public Health and National Solidarity ⁷⁶, the Ministry of Livestock and Animal Husbandry ⁷⁷, the Ministry of the Environment and Fisheries ⁷⁸ or the Ministry of Higher Education, Research, and Innovation ⁷⁹. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.) Chad has not submitted confidence building measures under the BWC. ⁸⁰ There is no evidence of such legislation and/or regulations in the Verification Research, Training and Information Centre (VERTIC) database. ⁸¹

1.3.1d Consolidation of especially dangerous pathogens into minimum # of facilities

Score: 0

There is insufficient evidence that Chad has taken action to consolidate its inventories of especially dangerous pathogens and toxins into a minimum number of facilities. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Biological Safety and Security” section that Chad “does not yet have legislation on biosafety and biosecurity”, “No national strategy for waste management or the transport of biological samples has been implemented”, and “No inventory of pathogens has been conducted within facilities that store or handle these dangerous agents and toxins” (p. 26). ⁸² There is no evidence of action to consolidate Chad’s inventories of especially dangerous pathogens and toxins into a minimum number of facilities on the websites of the Ministry of Public Health and National Solidarity ⁸³, the Ministry of Livestock and Animal Husbandry ⁸⁴, the Ministry of the Environment and Fisheries ⁸⁵ or the Ministry of Higher Education, Research, and Innovation ⁸⁶. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.) Chad has not submitted confidence building measures under the BWC. ⁸⁷ There is no evidence of such legislation and/or regulations in the Verification Research, Training and Information Centre (VERTIC) database. ⁸⁸

1.3.1e Capacity to conduct tests for anthrax/Ebola without culturing live pathogens

Score: 0

There is insufficient public evidence of in-country capacity to conduct Polymerase Chain Reaction (PCR)–based diagnostic testing for anthrax and/or Ebola, which would preclude culturing a live pathogen. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “National Laboratory System” section that “The laboratory system is able to offer one or two testing modalities, such as rapid diagnostic testing (antigens and antibodies) and microscopy services for pathogen detection. However, there is no formal strategy or procedure guiding the organization of testing capacity with a holistic, national approach” (p. 35). Further, “The country has the capacity to diagnose most common priority diseases (yellow fever, rabies, meningitis, etc.)” and “The capacity to perform molecular biology analyses exists in the country” (p. 35). However, the JEE does not specify that PCR testing is available. ⁸⁹ The website of the National Reference University Hospital Center (Centre Hospitalier Universitaire the National Reference — CHU-RN) does not contain evidence of the ability to carry out PCR-based testing. ⁹⁰ According to the WHO, during a 2024 hepatitis E outbreak, Chad had to send samples abroad for PCR-based testing: “Between 1 and 19 March 2024, a total of 40 samples were tested by PCR at the Institute Pasteur of Dakar, Sénégal, for hepatitis E, yellow fever, dengue, West Nile fever, Zika, chikungunya, Rift Valley fever and Crimean-Congo haemorrhagic fever.” ⁹¹ There is no evidence of the availability of PCR-based testing on the websites of the Ministry of Public Health and National Solidarity ⁹², the Ministry of Livestock and Animal Husbandry ⁹³, the Ministry of the Environment and Fisheries ⁹⁴ or the Ministry of Higher Education, Research, and Innovation ⁹⁵.

1.3.2a Biosecurity training using a standardised, required approach

Score: 33.33

There is insufficient evidence that Chad requires biosecurity training, using a standardized, required approach, such as through a common curriculum or a train-the-trainer program, for personnel working in facilities housing or working with especially dangerous pathogens, toxins, or biological materials with pandemic potential; however, there is evidence of ad-hoc training. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Biological Safety and Security” section that Chad “does not yet have legislation on biosafety and biosecurity” and “has not yet implemented a sustainable curriculum within institutions that train personnel responsible for storing or handling dangerous pathogens and toxins” (p. 26). Further, “Training has been conducted, but no sustainable training program on biosafety and biosecurity has been implemented” and “no plan for biosafety and biosecurity is available” (p. 27). ⁹⁶ There is no evidence of required biosecurity training, using a standardized, required approach on the websites of the Ministry of Public Health and National Solidarity ⁹⁷, the Ministry of Livestock and Animal Husbandry ⁹⁸, the Ministry of the Environment and Fisheries ⁹⁹ or the Ministry of Higher Education, Research, and Innovation ¹⁰⁰. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.) Chad has not submitted confidence building measures under the BWC. ¹⁰¹ There is no evidence of such legislation and/or regulations in the Verification Research, Training and Information Centre (VERTIC) database. ¹⁰²

1.3.3a Personnel checks for permission to access to especially dangerous pathogens

Score: 0

There is insufficient evidence that regulations or licensing conditions specify that security and other personnel with access to especially dangerous pathogens, toxins, or biological materials with pandemic potential are subject to checks in Chad. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Biological Safety and Security” section that Chad “does not yet have legislation on biosafety and biosecurity,” “has not yet implemented a sustainable curriculum within institutions that train personnel responsible for storing or handling dangerous pathogens and toxins” and “No national strategy for waste management or the transport of biological samples has been implemented” (p. 26). Further, “Training has been conducted, but no sustainable training program on biosafety and biosecurity has been implemented” and “no plan for biosafety and biosecurity is available” (p. 27). ¹⁰³ There is no evidence of regulations or licensing conditions on the websites of the Ministry of Public Health and National Solidarity ¹⁰⁴, the Ministry of Livestock and Animal Husbandry ¹⁰⁵, the Ministry of the Environment and Fisheries ¹⁰⁶ or the Ministry of Higher Education, Research, and Innovation ¹⁰⁷. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.) Chad has not submitted confidence building measures under the BWC. ¹⁰⁸ There is no evidence of such legislation and/or regulations in the Verification Research, Training and Information Centre (VERTIC) database. ¹⁰⁹

1.3.4a National transport regulations for Category A and B infectious substances

Score: 0

There is insufficient evidence that Chad has national regulations on the safe and secure transport of infectious substances (specifically including Categories A and B). The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Biological Safety and Security” section that Chad “does not yet have legislation on biosafety and biosecurity,” “has not yet implemented a sustainable curriculum within institutions that train personnel responsible for storing or handling dangerous pathogens and toxins” and “No national strategy for waste management or the transport of biological samples has been implemented” (p. 26). Further, “Training has been conducted, but no sustainable training program on biosafety and biosecurity has been implemented” and “no plan for biosafety and biosecurity is available” (p. 27). ¹¹⁰ There is no evidence of national regulations on the safe and secure transport of infectious substances on the websites of the Ministry of Public Health and National Solidarity ¹¹¹, the Ministry of Livestock and Animal Husbandry ¹¹², the Ministry of the Environment and Fisheries ¹¹³ or the Ministry of Higher Education, Research, and Innovation ¹¹⁴. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.) Chad has not submitted confidence building measures under the BWC. ¹¹⁵ There is no evidence of such legislation and/or regulations in the VERTIC database. ¹¹⁶ An October 13, 2025 Facebook post from the Ministry of Public Health and National Solidarity reported that an integrated strategic plan to transport biological samples using a One Health approach was in the process of being developed with the help of the Pandemic Fund and the WHO. ¹¹⁷

1.3.5a Laws/regulations on cross-border transfer and end-user screening

Score: 0

There is insufficient evidence that Chad has legislation and/or regulations in place to oversee the cross-border transfer and end-user screening of especially dangerous pathogens, toxins, and pathogens with pandemic potential. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Biological Safety and Security” section that Chad “does not yet have legislation on biosafety and biosecurity,” “has not yet implemented a sustainable curriculum within institutions that train personnel responsible for storing or handling dangerous pathogens and toxins” and “No national strategy for waste management or the transport of biological samples has been implemented” (p. 26). Further, “Training has been conducted, but no sustainable training program on biosafety and biosecurity has been implemented” and “no plan for biosafety and biosecurity is available” (p. 27). ¹¹⁸ There is no evidence of legislation and/or regulations in place to oversee the cross-border transfer and end-user screening of especially dangerous pathogens, toxins, and pathogens with pandemic potential on the websites of the Ministry of Public Health and National Solidarity ¹¹⁹, the Ministry of Livestock and Animal Husbandry ¹²⁰, the Ministry of the Environment and Fisheries ¹²¹ or the Ministry of Higher Education, Research, and Innovation ¹²². (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.) Chad has not submitted confidence building measures under the BWC. ¹²³ There is no evidence of such legislation and/or regulations in the Verification Research, Training and Information Centre (VERTIC) database. ¹²⁴

1.4.1a Biosafety laws/regulations

Score: 0

There is insufficient evidence that Chad has national biosafety legislation and/or regulations. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Biological Safety and Security” section that Chad “does not yet have legislation on biosafety and biosecurity,” “has not yet implemented a sustainable curriculum within institutions that train personnel responsible for storing or handling dangerous pathogens and toxins” and “No national strategy for waste management or the transport of biological samples has been implemented” (p. 26). ¹²⁵ There is no evidence of national biosafety legislation and/or regulations on the websites of the Ministry of Public Health and National Solidarity ¹²⁶, the Ministry of Livestock and Animal Husbandry ¹²⁷, the Ministry of the Environment and Fisheries ¹²⁸ or the Ministry of Higher Education, Research, and Innovation ¹²⁹. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.) Chad has not submitted confidence building measures under the BWC. ¹³⁰ There is no evidence of such legislation and/or regulations in the Verification Research, Training and Information Centre (VERTIC) database. ¹³¹

1.4.1b Agency for enforcement of biosafety laws/regulations

Score: 0

There is insufficient evidence that Chad has an established agency responsible for the enforcement of biosafety legislation and regulations. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Biological Safety and Security” section that Chad “does not yet have legislation on biosafety and biosecurity,” “has not yet implemented a sustainable curriculum within institutions that train personnel responsible for storing or handling dangerous pathogens and toxins” and “No national strategy for waste management or the transport of biological samples has been implemented” (p. 26). ¹³² There is no evidence of an established agency responsible for the enforcement of biosafety legislation and regulations on the websites of the Ministry of Public Health and National Solidarity ¹³³, the Ministry of Livestock and Animal Husbandry ¹³⁴, the Ministry of the Environment and Fisheries ¹³⁵ or the Ministry of Higher Education, Research, and Innovation ¹³⁶. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.) Chad has not submitted confidence building measures under the BWC. ¹³⁷ There is no evidence of such legislation and/or regulations in the Verification Research, Training and Information Centre (VERTIC) database. ¹³⁸

1.4.2a Biosafety training using a standardised, required approach

Score: 0

There is insufficient evidence that Chad requires biosafety training, using a standardized, required approach, such as through a common curriculum or a train-the-trainer program, for personnel working in facilities housing or working with especially dangerous pathogens, toxins, or biological materials with pandemic potential. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Biological Safety and Security” section that Chad “does not yet have legislation on biosafety and biosecurity” and “has not yet implemented a sustainable curriculum within institutions that train personnel responsible for storing or handling dangerous pathogens and toxins” (p. 26). Further, “Training has been conducted, but no sustainable training program on biosafety and biosecurity has been implemented” and “no plan for biosafety and biosecurity is available” (p. 27). ¹³⁹ There is no evidence of required biosafety training, using a standardized, required approach on the websites of the Ministry of Public Health and National Solidarity ¹⁴⁰, the Ministry of Livestock and Animal Husbandry ¹⁴¹, the Ministry of the Environment and Fisheries ¹⁴² or the Ministry of Higher Education, Research, and Innovation ¹⁴³. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.) Chad has not submitted confidence building measures under the BWC. ¹⁴⁴ There is no evidence of such legislation and/or regulations in the Verification Research, Training and Information Centre (VERTIC) database. ¹⁴⁵

1.5.1a Evidence of national assessment of dual-use research

Score: 0

There is insufficient evidence that Chad has conducted an assessment to determine whether ongoing research is occurring on especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Biological Safety and Security” section that Chad “does not yet have legislation on biosafety and biosecurity”, “No national strategy for waste management or the transport of biological samples has been implemented”, and “No inventory of pathogens has been conducted within facilities that store or handle these dangerous agents and toxins” (p. 26). ¹⁴⁶ There is no evidence of an assessment to determine whether ongoing research is occurring on especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research on the websites of the Ministry of Public Health and National Solidarity ¹⁴⁷, the Ministry of Livestock and Animal Husbandry ¹⁴⁸, the Ministry of the Environment and Fisheries ¹⁴⁹ or the Ministry of Higher Education, Research, and Innovation ¹⁵⁰. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.) Chad has not submitted confidence building measures under the BWC. ¹⁵¹ There is no evidence of such legislation and/or regulations in the Verification Research, Training and Information Centre (VERTIC) database. ¹⁵²

1.5.1b National law/regulation on oversight of dual-use research

Score: 0

There is insufficient evidence that Chad has legislation and/or regulation requiring oversight of research with especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Biological Safety and Security” section that Chad “does not yet have legislation on biosafety and biosecurity”, “No national strategy for waste management or the transport of biological samples has been implemented”, and “No inventory of pathogens has been conducted within facilities that store or handle these dangerous agents and toxins” (p. 26). ¹⁵³ There is no evidence of legislation and/or regulation requiring oversight of research with especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research on the websites of the Ministry of Public Health and National Solidarity ¹⁵⁴, the Ministry of Livestock and Animal Husbandry ¹⁵⁵, the Ministry of the Environment and Fisheries ¹⁵⁶ or the Ministry of Higher Education, Research, and Innovation ¹⁵⁷. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.) Chad has not submitted confidence building measures under the BWC. ¹⁵⁸ There is no evidence of such legislation and/or regulations in the Verification Research, Training and Information Centre (VERTIC) database. ¹⁵⁹

1.5.1c Existence of agency responsible for oversight of dual-use research

Score: 0

There is insufficient evidence that Chad has an agency responsible for oversight of research with especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Biological Safety and Security” section that Chad “does not yet have legislation on biosafety and biosecurity”, “No national strategy for waste management or the transport of biological samples has been implemented”, and “No inventory of pathogens has been conducted within facilities that store or handle these dangerous agents and toxins” (p. 26). ¹⁶⁰ There is no evidence of an agency responsible for oversight of research with especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research on the websites of the Ministry of Public Health and National Solidarity ¹⁶¹, the Ministry of Livestock and Animal Husbandry ¹⁶², the Ministry of the Environment and Fisheries ¹⁶³ or the Ministry of Higher Education, Research, and Innovation ¹⁶⁴. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.) Chad has not submitted confidence building measures under the BWC. ¹⁶⁵ There is no evidence of such legislation and/or regulations in the Verification Research, Training and Information Centre (VERTIC) database. ¹⁶⁶

1.5.2a Requirement to screen synthesised DNA against list prior to sale

Score: 0

There is insufficient evidence that Chad has legislation and/or regulation requiring the screening of synthesized DNA (deoxyribonucleic acid) against lists of known pathogens and toxins before it is sold. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Biological Safety and Security” section that Chad “does not yet have legislation on biosafety and biosecurity”, “No national strategy for waste management or the transport of biological samples has been implemented”, and “No inventory of pathogens has been conducted within facilities that store or handle these dangerous agents and toxins” (p. 26). ¹⁶⁷ There is no evidence of legislation and/or regulation requiring the screening of synthesized DNA (deoxyribonucleic acid) against lists of known pathogens and toxins before it is sold on the websites of the Ministry of Public Health and National Solidarity ¹⁶⁸, the Ministry of Livestock and Animal Husbandry ¹⁶⁹, the Ministry of the Environment and Fisheries ¹⁷⁰ or the Ministry of Higher Education, Research, and Innovation ¹⁷¹. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.) Chad has not submitted confidence building measures under the BWC. ¹⁷² There is no evidence of such legislation and/or regulations in the Verification Research, Training and Information Centre (VERTIC) database. ¹⁷³

1.6.1a Immunization rate for humans (measles/MCV2)

Score: 0

1.6.1b Availability of vaccination figures for livestock (FMD) through OIE database

Score: 0

There is insufficient evidence that official foot-and-mouth disease (FMD) vaccination figures for livestock are publicly available through the WOAH database for Chad. The WAHIS database, maintained by the World Organization for Animal Health (WOAH) does not contain vaccination figures for Chad. ¹⁷⁴

1.6.1c Equitablenature of national immunization strategy/plan

Score: 0

There is evidence of a national immunization strategy/plan but it is not publicly available; however, there is evidence that Chad’s vaccination plans include a focus on equitable distribution and strategies to overcome geographic and cultural barriers to vaccination. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Vaccination” section that Chad should “Develop the new national vaccination strategy (SNV) taking into account vaccination against zoonotic diseases” (p. 30). The JEE also notes that “Several strengths have been observed, including the implementation of a national program for the health of nomadic populations, islanders, and people living in areas with difficult access, which has improved vaccination coverage; the implementation of a plan to improve data quality; and the financing of micro plans to reach each district (ACD) / assessment of coverage and equity (ACE)” (p. 29). ¹⁷⁵ According to an October 2, 2025 Facebook post from the Vaccination Directorate of Chad (Direction de la Vaccination Tchad), the new National Vaccination Strategy 2026-2030 (Stratégie Nationale de Vaccination 2026-2030) (SNV), was reviewed and validated as part of a meeting of the Interagency Coordination Committee (CCIA) but has not yet been released. ¹⁷⁶ The 2026-2030 SNV is not available on the websites of the Ministry of Public Health and National Solidarity ¹⁷⁷ or GAVI, the Vaccine Alliance ¹⁷⁸.

1.6.1d Vaccine hesitancy and build public trust coverage in vaccines in national immunization strategy/plans

Score: 0

There is evidence of a national immunization strategy/plan in Chad but it is not publicly available. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Vaccination” section that Chad should “Develop the new national vaccination strategy (SNV) taking into account vaccination against zoonotic diseases” (p. 30). ¹⁷⁹ According to an October 2, 2025 Facebook post from the Vaccination Directorate of Chad (Direction de la Vaccination Tchad), the new National Vaccination Strategy 2026-2030 (Stratégie Nationale de Vaccination 2026-2030) (SNV), was reviewed and validated as part of a meeting of the Interagency Coordination Committee (CCIA) but has not yet been released. ¹⁸⁰The 2026-2030 SNV is not available on the websites of the Ministry of Public Health and National Solidarity ¹⁸¹ or GAVI, the Vaccine Alliance ¹⁸².

1.6.1e National advisory group for immunization strategy/plan

Score: 100

Chad has a national advisory group that provides technical guidance and advice on the immunization strategy/plan to the government. Decree No. 4464/PT/PM 2023. Concerning the creation, mandate, and operation of the Technical Advisory Group on Immunization in Chad (GTCV) established Chad’s national advisory group. Article 2 covers the GTCV’s responsibilities, which include “Analyze current national vaccination policies and strategies (routine vaccination, non-EPI vaccination, supplementary vaccination activities, epidemiological surveillance); and surveillance; Inform national authorities about the latest scientific developments and innovations in the field of vaccination and vaccines; Propose optimal strategies for controlling vaccine-preventable diseases; The introduction of new vaccines and new technologies, their impact on the health system and vaccination programs; The most recent knowledge concerning the safety and quality of vaccines, as well as the fight against new diseases that can be prevented through vaccination; Evaluate the accountability framework for vaccination; Evaluate interventions related to equity and integration of child survival activities; Regulation, vaccine safety including pharmacovigilance; Establish partnerships with other national independent expert committees for immunization and vaccines; [and] Other issues related to vaccines and immunization”. ¹⁸³ An August 2024 Facebook post from the Ministry of Public Health and National Solidarity reports that the Minister of Health met with the GTCV to discuss its activities and recommendations. ¹⁸⁴

1.6.1f Presence of an immunization programme for influenza

Score: 0

There is insufficient evidence that Chad has a national immunization programme for influenza. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” does not include evidence of such a program in the “Vaccination” section. ¹⁸⁵ The Vaccination Directorate of Chad (Direction de la Vaccination Tchad) reports in a May 14, 2025 Facebook post that it offers seasonal influenza vaccinations to pilgrims undergoing the Hajj but not for the general population. ¹⁸⁶ There is no evidence of a seasonal immunization program for influenza on the websites of the Ministry of Public Health and National Solidarity ¹⁸⁷ or GAVI, the Vaccine Alliance ¹⁸⁸.

1.7.1a Strategy/plan for resilience of health system

Score: 0

There is insufficient evidence that Chad has a strategy or plan to develop a health system that is resilient to the challenges that climate change and changing seasonal weather patterns pose, that includes the threat of infectious diseases. The First National Climate Change Adaptation Plan of Chad (2022) briefly covers some of the risks that climate change poses to health in the country in section 7.5, including “increased morbidity and mortality from vector- and non-vector-borne tropical diseases” (p. 55). However, neither that section nor the Priority Adaptation Measures and Options included in section 8 specifically address either improving the health system or addressing considerations that specifically cover the threat of infectious disease. ¹⁸⁹ While the National Strategy for the Promotion of Health and Well-Being 2024 – 2030 notes that there is no specific adaptation plan for the health sector (p. 44), it does include some objectives related to climate change. Section 3.5 includes “Conduct assessments of vulnerability and adaptation of the health sector to climate change: Health of older people, health of refugees, health of migrants” (p. 61). ¹⁹⁰ There was insufficient evidence of other strategies or plans on the websites of the Ministry of Public Health and National Solidarity ¹⁹¹, the Ministry of Livestock and Animal Husbandry ¹⁹², the Ministry of the Environment and Fisheries ¹⁹³ or the Ministry of Higher Education, Research, and Innovation ¹⁹⁴. The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unavailable at the time of research.

2.1.1a Capacity of national lab system to conduct 5 or more WHO core tests

Score: 50

There is evidence that Chad can conduct at least 5 of the 10 WHO-defined core tests but these tests are not named. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “National Laboratory System” section that “The laboratory system is able to offer one or two testing modalities, such as rapid diagnostic testing (antigens and antibodies) and microscopy services for pathogen detection. However, there is no formal strategy or procedure guiding the organization of testing capacity with a holistic, national approach” (p. 35). Further, “The country has the capacity to diagnose most common priority diseases (yellow fever, rabies, meningitis, etc.)” and “The capacity to perform molecular biology analyses exists in the country” (p. 35). ¹⁹⁵ The website of the National Reference University Hospital Center (Centre Hospitalier Universitaire the National Reference — CHU-RN) does not specify which tests are offered or are avaliable. ¹⁹⁶ According to the WHO, during a 2024 hepatitis E outbreak, Chad had to send samples abroad for PCR-based testing: “Between 1 and 19 March 2024, a total of 40 samples were tested by PCR at the Institute Pasteur of Dakar, Sénégal, for hepatitis E, yellow fever, dengue, West Nile fever, Zika, chikungunya, Rift Valley fever and Crimean-Congo haemorrhagic fever.” ¹⁹⁷ There is no further evidence of the availability of specific tests on the websites of the Ministry of Public Health and National Solidarity ¹⁹⁸, the Ministry of Livestock and Animal Husbandry ¹⁹⁹, the Ministry of the Environment and Fisheries ²⁰⁰ or the Ministry of Higher Education, Research, and Innovation ²⁰¹.

2.1.1b Plan to conduct testing during a public health emergency

Score: 0

There is insufficient evidence of a national plan, strategy or similar document for conducting testing during a public health emergency in Chad. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Management of Health Emergencies” section that Chad must see to “the development of the multi-risk plan within the framework of One Health” (p. 44). ²⁰² There is no evidence of a national plan, strategy or similar document for conducting testing during a public health emergency on the websites of the Ministry of Public Health and National Solidarity ²⁰³, the Ministry of Livestock and Animal Husbandry ²⁰⁴, the Ministry of the Environment and Fisheries ²⁰⁵ or the Ministry of Higher Education, Research, and Innovation ²⁰⁶. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

2.1.2a Existence of an accredited national lab serving as a reference facility

Score: 0

There is insufficient evidence of a national laboratory that serves as a reference facility which is accredited in Chad. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “National Laboratory System” section that “The laboratory of the general hospital in the capital is the national reference laboratory” (p. 33); the JEE does not contain evidence that this laboratory has international accreditation. ²⁰⁷ The website of the National Reference University Hospital Center (Centre Hospitalier Universitaire the National Reference — CHU-RN) reports that “The laboratory is generally accredited by regulatory bodies, guaranteeing the quality and reliability of the analyses” but does not specify any accreditation standard. ²⁰⁸ There is no evidence of a national laboratory that serves as a reference facility which is accredited on the websites of the Ministry of Public Health and National Solidarity ²⁰⁹, the Ministry of Livestock and Animal Husbandry ²¹⁰ the Ministry of the Environment and Fisheries ²¹¹ or the Ministry of Higher Education, Research, and Innovation ²¹². (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

2.1.2b External quality assurance of a national lab serving as a reference facility

Score: 0

There is insufficient evidence of a national laboratory that serves as a reference facility which is subject to external quality assurance review in Chad. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “National Laboratory System” section that “The laboratory of the general hospital in the capital is the national reference laboratory” (p. 33); the JEE does not contain evidence that this laboratory is subject to external quality assurance. ²¹³ The website of the National Reference University Hospital Center (Centre Hospitalier Universitaire the National Reference — CHU-RN) reports that “The laboratory is generally accredited by regulatory bodies, guaranteeing the quality and reliability of the analyses” but does not specify that it is subject to external quality assurance review. ²¹⁴ There is no evidence of a national laboratory that serves as a reference facility which is subject to external quality assurance review on the websites of the Ministry of Public Health and National Solidarity ²¹⁵, the Ministry of Livestock and Animal Husbandry ²¹⁶ the Ministry of the Environment and Fisheries ²¹⁷ or the Ministry of Higher Education, Research, and Innovation ²¹⁸. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

2.2.1a Nationwide specimen transport system

Score: 0

There is insufficient evidence that Chad has a nationwide specimen transport system. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “National Laboratory System” section that Chad “receives technical and financial support from the World Health Organization and the Africa Centers for Disease Control and Prevention (Africa CDC) for the transport of samples abroad” (p. 33); it also reports “The existence of good orientation and adequate/appropriate transport of medical biology samples for the diagnosis and/or confirmation of all priority diseases at all levels” but that “the transport of samples is not well structured for all laboratories as recommended, but uses ad hoc means of transport. Indeed, the existence and implementation of standard operating procedures (SOPs) for sending, receiving, storing, packaging and transporting samples from different sectors affecting public health have not been observed” (p. 34). ²¹⁹ There is no evidence of a nationwide specimen transport system on the websites of the Ministry of Public Health and National Solidarity ²²⁰, the Ministry of Livestock and Animal Husbandry ²²¹, the Ministry of the Environment and Fisheries ²²² or the Ministry of Higher Education, Research, and Innovation ²²³. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

2.2.2a Plan to rapidly authorize/license laboratories to scale-up testing during an outbreak

Score: 0

There is insufficient evidence that Chad has a plan in place to rapidly authorize or license laboratories to supplement the capacity of the national public health laboratory system to scale-up testing during an outbreak. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “National Laboratory System” section that “state laboratories are created by regulation and do not systematically receive a license or approval from a national body after assessing their skills. The quality system for medical biology laboratories, which is well established, has no equivalent for the rest of the country's laboratories. No national quality system (covering all laboratories concerned by the RSI areas concerning laboratory capacity) was observed” (p. 33). ²²⁴ There is no evidence of plan a place to rapidly authorize or license laboratories to supplement the capacity of the national public health laboratory system to scale-up testing during an outbreak on the websites of the Ministry of Public Health and National Solidarity ²²⁵, the Ministry of Livestock and Animal Husbandry ²²⁶, the Ministry of the Environment and Fisheries ²²⁷ or the Ministry of Higher Education, Research, and Innovation ²²⁸. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

2.3.1a Evidence of ongoing event-based and indicator-based surveillance and analysis

Score: 50

There is evidence that Chad is conducting ongoing event-based and indicator-based surveillance and analysis for notifiable and novel infectious diseases but no evidence that data is being analyzed on a daily basis.

The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Surveillance” section that “Surveillance is organized at all levels of the health system (national, provincial, and district)” and “At the national level, the Directorate for Disease Control and Epidemiological Surveillance (DLMSE) is responsible for coordinating surveillance activities. The country has a list of notifiable diseases that are monitored based on indicators and syndromic surveillance. The diseases under surveillance are measles, meningitis, yellow fever, cholera, poliomyelitis, neonatal tetanus (NNT), scorpion stings, Guinea worm (GW), and maternal deaths” (p. 37); the JEE does not report that data is analyzed on a daily basis. However, the JEE concludes that event-based surveillance is not fully in operation and recommends the “Operationalization of community-based surveillance (CBS) and event-based surveillance (EBS) across the country” (p. 38). ²²⁹ Information about the DLMSE and formal guidelines and plans are not available on the websites of the Ministry of Public Health and National Solidarity ²³⁰, the Ministry of Livestock and Animal Husbandry ²³¹, the Ministry of the Environment and Fisheries ²³² or the Ministry of Higher Education, Research, and Innovation ²³³. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

2.3.1b Evidence of a mechanism (such as IHR focal point) for reporting notifiable diseases to the WHO within the set timeline

Score: 100

There is publicly available evidence of an IHR focal point in Chad.

The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “IHR coordination, national IHR focal point functions and advocacy” section that “the IHR focal point is appointed, operational, and has good working relationships with the World Health Organization (WHO) local and regional IHR focal points. However, communicating health security information between the national focal point and other government sectors in order to submit reports to the World Health Organization (WHO) in a timely manner remains a challenge” (p. 13). ²³⁴ A 2024 report from the Disease Outbreak News section of the World Health Organization (WHO) confirms that Chad informed the WHO of a Hepatitis E outbreak through the IHR focal point. ²³⁵

2.3.2a Electronic national and sub-national reporting surveillance system

Score: 100

There is evidence that Chad operates an electronic reporting surveillance system at both the national and the sub-national level.

According to Chad’s National Health Development Plan (PNDS 2022 2030), a DHIS2 system has been deployed "at all levels" (central, provinces, districts) since July 2022. However, the report indicates that data quality remains an issue (incomplete collection, tool disruptions). ²³⁶
Further information about the DLMSE and formal guidelines and plans are not available on the websites of the Ministry of Public Health and National Solidarity ²³⁷, the Ministry of Livestock and Animal Husbandry ²³⁸, the Ministry of the Environment and Fisheries ²³⁹ or the Ministry of Higher Education, Research, and Innovation ²⁴⁰. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

2.3.2b Collection of ongoing/real-time lab data by electronic surveillance system

Score: 0

There is insufficient evidence that Chad's electronic reporting surveillance system collects ongoing or real-time laboratory data or that such data can be disaggregated and analysed by age, ethnicity, etc. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” does not contain evidence in the “Surveillance” section that an electronic reporting surveillance system collects real-time laboratory data. It recommends that Chad “Establish a systematic communication/information sharing mechanism for surveillance data within the One Health framework” (p. 39). ²⁴¹ There is no evidence of the analysis of real-time laboratory data on the websites of the Ministry of Public Health and National Solidarity ²⁴², the Ministry of Livestock and Animal Husbandry ²⁴³, the Ministry of the Environment and Fisheries ²⁴⁴ or the Ministry of Higher Education, Research, and Innovation ²⁴⁵. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

2.3.3a National wastewater surveillance programme or initiative

Score: 50

There is evidence of ongoing wastewater or environmental surveillance (ES) in Chad, although it is unclear whether this is national or sub-national. Chad began ES in Africa in 2014.²⁴⁶ Further, in 2016, under the Polio Environmental Surveillance Expansion Plan (PESEP), the GPEI began initiating ES implementation in six new countries (Burkina Faso, Cameroon, Chad, Guinea, Madagascar and Niger).²⁴⁷

As of 6 May 2026, GPEI, reported that no cVDPV2-positive environmental samples were reported this week (most recent positive environmental sample: 04 February 2026), suggesting that ES is conducted on a regular basis, although it is unclear whether this is at the national level.²⁴⁸

Moreover, the WHO and GPEI Q4 2025 Polio ES Bulletin lists the country as having 5 ES sites as of Q4 in 2025, although it is unclear whether these are at the national level and are ongoing.²⁴⁹

in 2024, the WHO and GPEI reported that Chad has engaged in ad-hoc ES, notably in 2019, 2022, 2023 and 2024. The report states that "while there has been substantial expansion of the environmental surveillance network, there are still gaps in site quality, including in areas with high transnational populations. Focused action is needed to address gaps and ensure high quality surveillance at all levels.". Figure 4 in the report shows limited ES performance at site level in Chad between July 2023 and June 2024.²⁵⁰

2.4.1a Common usage of electronic health records

Score: 0

There is insufficient evidence that electronic health records commonly in use or that they are used in Chad. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” does not contain evidence that electronic health records are in use in Chad. ²⁵¹ The 2024 National Strategy for the Promotion of Health and Well-Being 2024 – 2030 (Stratégie Nationale de Promotion de la Santé et du Bien Etre 2024 – 2030) (SNPSBE) does not discuss electronic health records. ²⁵² There is no evidence of the use of electronic health records on the websites of the Ministry of Public Health and National Solidarity ²⁵³, the Ministry of Livestock and Animal Husbandry ²⁵⁴, the Ministry of the Environment and Fisheries ²⁵⁵ or the Ministry of Higher Education, Research, and Innovation ²⁵⁶. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

2.4.1b Public health system access to individual electronic health records

Score: 0

There is insufficient evidence that electronic health records are in use in Chad. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” does not contain evidence that electronic health records are in use in Chad. ²⁵⁷ The 2024 National Strategy for the Promotion of Health and Well-Being 2024 – 2030 (Stratégie Nationale de Promotion de la Santé et du Bien Etre 2024 – 2030) (SNPSBE) does not discuss electronic health records. ²⁵⁸ There is no evidence of the use of electronic health records on the websites of the Ministry of Public Health and National Solidarity ²⁵⁹, the Ministry of Livestock and Animal Husbandry ²⁶⁰, the Ministry of the Environment and Fisheries ²⁶¹ or the Ministry of Higher Education, Research, and Innovation ²⁶². (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

2.4.1c Existence of data standards for health record data comparability

Score: 0

There is no evidence of standards to ensure data comparability. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” does not contain evidence that there are data standards for electronic health records in use in Chad. ²⁶³ The 2024 National Strategy for the Promotion of Health and Well-Being 2024 – 2030 (Stratégie Nationale de Promotion de la Santé et du Bien Etre 2024 – 2030) (SNPSBE) does not discuss electronic health records or standards for them. ²⁶⁴ There is no evidence of the use of electronic health records on the websites of the Ministry of Public Health and National Solidarity ²⁶⁵, the Ministry of Livestock and Animal Husbandry ²⁶⁶, the Ministry of the Environment and Fisheries ²⁶⁷ or the Ministry of Higher Education, Research, and Innovation ²⁶⁸. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

2.4.2a Data sharing mechanisms

Score: 0

There is insufficient evidence of established mechanisms at the relevant ministries responsible for animal, human, and wildlife surveillance to share data in Chad. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Surveillance” section that “there is no systematic communication between human surveillance and animal surveillance, except during epidemics (avian flu and rabies), even though these two sectors jointly organized the response to these two diseases during a recent event” (p. 38). The JEE recommends “Establish a systematic communication/information sharing mechanism for epidemiological surveillance data within the framework of the “One Health” concept” and “Establish a formal framework for collaboration between the Disease Control and Epidemiological Surveillance Directorate, the Public Health Emergency Operations Center, the Health Information System Directorate, and the Community Health Directorate” (p. 39). ²⁶⁹ The 2024 National Strategy for the Promotion of Health and Well-Being 2024 – 2030 (Stratégie Nationale de Promotion de la Santé et du Bien Etre 2024 – 2030) (SNPSBE) does not discuss creating a mechanism for sharing epidemiological data within the government. ²⁷⁰ There is no evidence of such mechanisms on the websites of the Ministry of Public Health and National Solidarity ²⁷¹, the Ministry of Livestock and Animal Husbandry ²⁷², the Ministry of the Environment and Fisheries ²⁷³ or the Ministry of Higher Education, Research, and Innovation ²⁷⁴. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

2.4.3a Availability of de-identified health surveillance data on disease outbreaks

Score: 0

There is insufficient evidence that Chad makes de-identified health surveillance data on infectious diseases publicly available via reports (or other formats) on government websites (such as the Ministry of Health, Ministry of Agriculture, or similar). While Chad made monthly reports on infectious diseases publically avaliable during COVID-19 ²⁷⁵, such documentation is no longer avaliable on the websites of the Ministry of Public Health and National Solidarity ²⁷⁶, the Ministry of Livestock and Animal Husbandry ²⁷⁷, the Ministry of the Environment and Fisheries ²⁷⁸ or the Ministry of Higher Education, Research, and Innovation ²⁷⁹. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.) The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Surveillance” section that “A monthly bulletin is regularly produced and serves as a support for the dissemination and feedback of surveillance data. The data is also shared with the World Health Organization (WHO) in an Excel file” (p. 37); however, that bulletin is not available publicly. ²⁸⁰

2.4.4a Confidentiality legislation/regulations for identifiable health information

Score: 100

There is publicly available evidence that Chad has laws or guidelines that safeguard the confidentiality of identifiable health information for individuals, such as that generated through health surveillance activities. Act No. 007/PR/2015 of February 10, 2015, on Personal Data protection (‘The Act’) (Loi N°007/PR/2015 portant Protection des Données à Caractère Personnel. Voir La Loi N°007) includes specific provisions safeguarding health information. Article 16 of the law defines “Special categories of data” and prohibits their processing without consent or in limited circumstances: “The processing of biometric data and personal data which, if processed for what they reveal or contain, reveal racial or ethnic origin, parentage, political opinions, religious or philosophical beliefs, trade union membership, sex, as well as the processing of data concerning health and sex life is prohibited unless: a) the data subject has given their explicit written consent, whether on paper, electronically, or any other equivalent medium, to such processing, except where the law provides that the prohibition referred to in paragraph 1 cannot be lifted by the data subject's written consent;”. ²⁸¹ Further data that is collected is subject to strict safeguards. Article 59 covers data security: “The processing of personal data is confidential. It is carried out exclusively by persons acting under the authority of the data controller or their subcontractor and only on their instructions. For the processing of personal data, the data controller or their subcontractor must choose persons who, with regard to preserving data confidentiality, provide all the necessary guarantees of technical and legal knowledge and personal integrity. A written undertaking to comply with this law must be signed by the persons processing such data.” Article 61 covers security obligations: “The controller and/or its processor are required to implement appropriate technical and organizational measures to protect personal data, in particular to prevent them from being distorted, damaged, or accessed by unauthorized third parties. In particular, it shall take all measures aimed at: a) ensuring that, when using an automated data processing system, authorized persons may only access personal data within their competence; b) ensuring that the identity of third parties to whom personal data may be transmitted can be verified and established; c) ensuring that the identity of the persons who have had access to the information system and what data have been read or entered into the system, at what time, and by which person can be verified and established retrospectively; d) preventing any unauthorized person from accessing the premises and equipment used for data processing; e) preventing data carriers from being read, copied, modified, destroyed, or moved by an unauthorized person;”. ²⁸²

2.4.4b Inclusion of cyber protections in health data confidentiality law/regulation

Score: 100

There is publicly available evidence that Chad has laws or guidelines safeguarding the confidentiality of identifiable health information for individuals, such as that generated through health surveillance activities, include mention of protections from cyber attacks. Act No. 007/PR/2015 of February 10, 2015, on Personal Data protection (‘The Act’) (Loi N°007/PR/2015 portant Protection des Données à Caractère Personnel. Voir La Loi N°007) includes specific provisions safeguarding health information. Article 16 of the law defines “Special categories of data” and prohibits their processing without consent or in limited circumstances: “The processing of biometric data and personal data which, if processed for what they reveal or contain, reveal racial or ethnic origin, parentage, political opinions, religious or philosophical beliefs, trade union membership, sex, as well as the processing of data concerning health and sex life is prohibited unless: a) the data subject has given their explicit written consent, whether on paper, electronically, or any other equivalent medium, to such processing, except where the law provides that the prohibition referred to in paragraph 1 cannot be lifted by the data subject's written consent;”. ²⁸³ Further data that is collected is subject to strict safeguards. Article 59 covers data security: “The processing of personal data is confidential. It is carried out exclusively by persons acting under the authority of the data controller or their subcontractor and only on their instructions. For the processing of personal data, the data controller or their subcontractor must choose persons who, with regard to preserving data confidentiality, provide all the necessary guarantees of technical and legal knowledge and personal integrity. A written undertaking to comply with this law must be signed by the persons processing such data.” Article 61 covers security obligations: “The controller and/or its processor are required to implement appropriate technical and organizational measures to protect personal data, in particular to prevent them from being distorted, damaged, or accessed by unauthorized third parties. In particular, it shall take all measures aimed at: a) ensuring that, when using an automated data processing system, authorized persons may only access personal data within their competence; b) ensuring that the identity of third parties to whom personal data may be transmitted can be verified and established; c) ensuring that the identity of the persons who have had access to the information system and what data have been read or entered into the system, at what time, and by which person can be verified and established retrospectively; d) preventing any unauthorized person from accessing the premises and equipment used for data processing; e) preventing data carriers from being read, copied, modified, destroyed, or moved by an unauthorized person;”. ²⁸⁴

2.4.5a Cooperative commitments or agreements within regions

Score: 100

There is evidence that Chad has made a commitment via public statements, legislation and/or a cooperative agreement to share surveillance data for two diseases during a public health emergency with other countries in the region. Chad was a signatory to the Abuja Commitment in 2010, which commits it to share information on cross-border public health issues with the World Health Organisation (WHO) and sub-regional health organisations to enable joint planning, coordination and timely response to disease outbreaks. ²⁸⁵ Under the Abuja Commitment, in 2016 and again in 2018 Cameroon participated in developing roadmaps for sub-regional collaboration and information-sharing on cholera in the Chad Basin area; Chad is one of the countries implementing the regional strategy for cholera in West and Central Africa, which involves strengthening cross-border collaboration in the surveillance and response to cholera epidemics between the countries of the Lake Chad Basin. ²⁸⁶²⁸⁷

Chad is part of the Regional Sahel Pastoralism Support Project which has as its main objective to enhance the sharing of animal health information and to implement regional transboundary programs for disease surveillance and control to ameliorate animal health and collectively manage animal health emergencies. Nevertheless, it is not specified that the surveillance data exchange occurs during a public health emergency. ²⁸⁸ Chad as a member of the WHO influenza network, is part of "an extensive international network of laboratories that conducts the necessary surveillance and provides WHO with the information it required to advise its Member States on the most effective influenza control measures". ²⁸⁹ Within the Lake Chad Basin, the 2024 plan for polio eradication calls for “regular sharing of vaccination and disease surveillance data between all partners and neighboring countries” (p.2) and sets up coordination channels between neighbouring health authorities (p.11). ²⁹⁰

The country's adherence to the International Health Regulations (IHR 2005) serves as a primary legal and operational commitment. As a signatory, Chad is obligated to notify the World Health Organization (WHO) of public health events that may constitute a public health emergency of international concern. This legally binding framework necessitates the sharing of surveillance data with the WHO but does not specify provisions to share with other countries. ²⁹¹

2.5.1a National support to conduct contact tracing in the event of a public health emergency

Score: 0

There is insufficient evidence that Chad has a national system in place to provide support at the sub-national level (e.g. training, metrics standardization and/or financial resources) to conduct contact tracing in the event of a public health emergency. Chad does not have an overarching national public health emergency response plan in place. The World Health Organization's (WHO) 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Management of Health Emergencies” section that Chad must see to “the development of the multi-risk plan within the framework of One Health, the development of a [Public Health Emergency Operations Center (Centre des Opérations d'Urgence en Santé Publique, COUSP)] human resources development plan and the provision of additional staff for public health emergency interventions” (p. 44) and “The development of relevant standard operating procedures for the management of health emergencies” (p. 46). ²⁹² There is no evidence of an overarching national public health emergency response plan on the websites of the Ministry of Public Health and National Solidarity ²⁹³, the Ministry of Livestock and Animal Husbandry ²⁹⁴, the Ministry of the Environment and Fisheries ²⁹⁵ or the Ministry of Higher Education, Research, and Innovation ²⁹⁶. The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were inaccessible at the time of research.

Per WHO and World Bank information, Chad conducted a National Action Plan for Health Security (NAPHS) workshop in 2018, had a National Action Plan for Health Security (NAPHS) covering 2018-2021, and conducted another NAPHS workshop in 2024. ²⁹⁷²⁹⁸ Neither the 2018-2021 NAPHS nor any follow-up plan, however, is available through Chadian government websites or through the WHO. ^{299300301302303304}

2.5.1b Provision of wraparound services to enable self-isolation/quarantine as recommended

Score: 0

There is insufficient evidence that Chad provides wraparound services to enable infected people and their contacts to self-isolate or quarantine as recommended, particularly economic support (paycheck, job security) and medical attention. Chad does not have an overarching national public health emergency response plan in place. The World Health Organization's (WHO) 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Management of Health Emergencies” section that Chad must see to “the development of the multi-risk plan within the framework of One Health, the development of a [Public Health Emergency Operations Center (Centre des Opérations d'Urgence en Santé Publique, COUSP)] human resources development plan and the provision of additional staff for public health emergency interventions” (p. 44) and “The development of relevant standard operating procedures for the management of health emergencies” (p. 46). ³⁰⁵ There is no evidence of an overarching national public health emergency response plan on the websites of the Ministry of Public Health and National Solidarity ³⁰⁶, the Ministry of Livestock and Animal Husbandry ³⁰⁷, the Ministry of the Environment and Fisheries ³⁰⁸ or the Ministry of Higher Education, Research, and Innovation ³⁰⁹. The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were inaccessible at the time of research.

Per WHO and World Bank information, Chad conducted a National Action Plan for Health Security (NAPHS) workshop in 2018, had a National Action Plan for Health Security (NAPHS) covering 2018-2021, and conducted another NAPHS workshop in 2024. ³¹⁰³¹¹ Neither the 2018-2021 NAPHS nor any follow-up plan, however, is available through Chadian government websites or through the WHO. ^{312313314315316317}

2.5.2a Strategy for tracing and quarantining international travelers

Score: 0

There is insufficient evidence that there is a system in place. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Points of Entry and Border Health” section that “Designated ports of entry do not have access to diagnostic facilities to quickly examine and treat sick travelers. These ports of entry do not provide adequate equipment and personnel to transport sick travelers to appropriate medical services. These ports of entry do not implement an inspection program to ensure the hygiene of services at the ports of entry or specific programs to control vectors and reservoirs. There is no national response plan to respond to public health emergencies occurring at points of entry” (p. 60). ³¹⁸ There is no evidence of a joint plan or cooperative agreement between the public health system and border control authorities to identify suspected and potential cases in international travelers and trace and quarantine their contacts in the event of a public health emergency on the websites of the Ministry of Public Health and National Solidarity ³¹⁹, the Ministry of Livestock and Animal Husbandry ³²⁰, the Ministry of the Environment and Fisheries ³²¹ or the Ministry of Higher Education, Research, and Innovation ³²². (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

2.6.1a Access to field epidemiology training program in country and/or abroad

Score: 100

Chad has an applied epidemiology training program (the FETP) available but there is insufficient evidence that it sends citizens to other countries to participate in such programs. The African Field Epidemiology Network (AFENET) reports that Chad established a FETP in 2022 with the cooperation of the US CDC; it has graduated 38 individuals as of January 2025. ³²³ There is no evidence that Chad sends citizens abroad to participate in such programs on the websites of the websites of the Ministry of Public Health and National Solidarity ³²⁴, the Ministry of Livestock and Animal Husbandry ³²⁵, the Ministry of the Environment and Fisheries ³²⁶ or the Ministry of Higher Education, Research, and Innovation ³²⁷. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

2.6.1b Existence of field epidemiology training for animal health professionals

Score: 0

There is insufficient evidence that field epidemiology training programs are explicitly inclusive of animal health professionals or that there is a specific animal health field epidemiology training program offered in Chad. While there is evidence, according to a new site, that Chad conducted a FETPV training in 2025 under the REPIMAT project (Epidemiological and Prevention Network for Transboundary Animal Diseases), it appears to have been a one-off event. ³²⁸ There is no evidence that Chad maintains such programs on the websites of the websites of the Ministry of Public Health and National Solidarity ³²⁹, the Ministry of Livestock and Animal Husbandry ³³⁰, the Ministry of the Environment and Fisheries ³³¹ or the Ministry of Higher Education, Research, and Innovation ³³². (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

2.6.2a Evidence of at least 1 trained field epidemiologist per 200,000 people

Score: 0

There is insufficient evidence that Chad has 1 trained field epidemiologist per 200,000 people. The African Field Epidemiology Network (AFENET) reports that Chad established an FETP in 2022 with the cooperation of the US CDC; it has graduated 38 individuals as of January 2025. ³³³ With Chad’s population being 20 million, that means there is only 1 trained field epidemiologist per 526,316 people.

3.1.1a National emergency response plan for diseases with pandemic potential

Score: 0

There is insufficient evidence that Chad has an overarching national public health emergency response plan in place which addresses planning for multiple communicable diseases with epidemic or pandemic potential. The World Health Organization's (WHO) 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Management of Health Emergencies” section that Chad must see to “the development of the multi-risk plan within the framework of One Health, the development of a [Public Health Emergency Operations Center (Centre des Opérations d'Urgence en Santé Publique, COUSP)] human resources development plan and the provision of additional staff for public health emergency interventions” (p. 44) and “The development of relevant standard operating procedures for the management of health emergencies” (p. 46). ³³⁴ There is no evidence of an overarching national public health emergency response plan on the websites of the Ministry of Public Health and National Solidarity ³³⁵, the Ministry of Livestock and Animal Husbandry ³³⁶, the Ministry of the Environment and Fisheries ³³⁷ or the Ministry of Higher Education, Research, and Innovation ³³⁸. The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were inaccessible at the time of research.

Per WHO and World Bank information, Chad conducted a National Action Plan for Health Security (NAPHS) workshop in 2018, had a National Action Plan for Health Security (NAPHS) covering 2018-2021, and conducted another NAPHS workshop in 2024. ³³⁹³⁴⁰ Neither the 2018-2021 NAPHS nor any follow-up plan, however, is available through Chadian government websites or through the WHO. ^{341342343344345346}

3.1.1b National public health emergency response plan published in past 3 years

Score: 0

There is insufficient evidence that Chad has an overarching national public health emergency response plan in place which addresses planning for multiple communicable diseases with epidemic or pandemic potential. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Management of Health Emergencies” section that Chad must see to “the development of the multi-risk plan within the framework of One Health, the development of a [Public Health Emergency Operations Center (Centre des Opérations d'Urgence en Santé Publique, COUSP)] human resources development plan and the provision of additional staff for public health emergency interventions” (p. 44) and “The development of relevant standard operating procedures for the management of health emergencies” (p. 46). ³⁴⁷ There is no evidence of an overarching national public health emergency response plan on the websites of the Ministry of Public Health and National Solidarity ³⁴⁸, the Ministry of Livestock and Animal Husbandry ³⁴⁹, the Ministry of the Environment and Fisheries ³⁵⁰ or the Ministry of Higher Education, Research, and Innovation ³⁵¹. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

Per WHO and World Bank information, Chad had a National Action Plan for Health Security (NAPHS) covering 2018-2021, and conducted an NAPHS workshop in 2024. ³⁵²³⁵³ Neither the 2018-2021 NAPHS nor any follow-up plan, however, is available through Chadian government websites or through the WHO. ^{354355356357358359}

3.1.1c One health principles by covering multiple threat types

Score: 0

There is insufficient evidence that Chad has an overarching national public health emergency response plan in place that addresses planning for multiple communicable diseases with epidemic or pandemic potential; therefore, Chad does not have a plan that follows one health principles by covering multiple threat types. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Management of Health Emergencies” section that Chad must see to “the development of the multi-risk plan within the framework of One Health, the development of a [Public Health Emergency Operations Center (Centre des Opérations d'Urgence en Santé Publique, COUSP)] human resources development plan and the provision of additional staff for public health emergency interventions” (p. 44) and “The development of relevant standard operating procedures for the management of health emergencies” (p. 46). ³⁶⁰ There is no evidence of an overarching national public health emergency response plan on the websites of the Ministry of Public Health and National Solidarity ³⁶¹, the Ministry of Livestock and Animal Husbandry ³⁶², the Ministry of the Environment and Fisheries ³⁶³ or the Ministry of Higher Education, Research, and Innovation ³⁶⁴. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

3.1.1d Vulnerable populations in national public health emergency response plan

Score: 0

There is insufficient evidence that Chad has an overarching national public health emergency response plan in place which addresses planning for multiple communicable diseases with epidemic or pandemic potential. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Management of Health Emergencies” section that Chad must see to “the development of the multi-risk plan within the framework of One Health, the development of a [Public Health Emergency Operations Center (Centre des Opérations d'Urgence en Santé Publique, COUSP)] human resources development plan and the provision of additional staff for public health emergency interventions” (p. 44) and “The development of relevant standard operating procedures for the management of health emergencies” (p. 46). ³⁶⁵ There is no evidence of an overarching national public health emergency response plan on the websites of the Ministry of Public Health and National Solidarity ³⁶⁶, the Ministry of Livestock and Animal Husbandry ³⁶⁷, the Ministry of the Environment and Fisheries ³⁶⁸ or the Ministry of Higher Education, Research, and Innovation ³⁶⁹. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

3.1.2a Mechanism to engage private sector in outbreak preparedness/response

Score: 0

There is insufficient evidence that Chad has an overarching national public health emergency response plan in place which would include plans for engaging with the private sector to assist with outbreak emergency preparedness and response. The World Health Organization's (WHO) 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Management of Health Emergencies” section that Chad must see to “the development of the multi-risk plan within the framework of One Health, the development of a [Public Health Emergency Operations Center (Centre des Opérations d'Urgence en Santé Publique, COUSP)] human resources development plan and the provision of additional staff for public health emergency interventions” (p. 44) and “The development of relevant standard operating procedures for the management of health emergencies” (p. 46). ³⁷⁰ There is no evidence of an overarching national public health emergency response plan on the websites of the Ministry of Public Health and National Solidarity ³⁷¹, the Ministry of Livestock and Animal Husbandry ³⁷², the Ministry of the Environment and Fisheries ³⁷³ or the Ministry of Higher Education, Research, and Innovation ³⁷⁴. The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were inaccessible at the time of research.

Per WHO and World Bank information, Chad conducted a National Action Plan for Health Security (NAPHS) workshop in 2018, had a National Action Plan for Health Security (NAPHS) covering 2018-2021, and conducted another NAPHS workshop in 2024. ³⁷⁵³⁷⁶ Neither the 2018-2021 NAPHS nor any follow-up plan, however, is available through Chadian government websites or through the WHO. ^{377378379380381382}
.

3.1.3a Policy/plan/guidelines in place to implement non-pharmaceutical interventions (NPIs)

Score: 50

There is evidence that Chad has a policy, plan and/or guidelines in place to implement non-pharmaceutical interventions (NPIs) during an epidemic or pandemic but only for one disease. The World Health Organization's (WHO) 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Management of Health Emergencies” section that Chad must see to “the development of the multi-risk plan within the framework of One Health, the development of a [Public Health Emergency Operations Center (Centre des Opérations d'Urgence en Santé Publique, COUSP)] human resources development plan and the provision of additional staff for public health emergency interventions” (p. 44) and “The development of relevant standard operating procedures for the management of health emergencies” (p. 46). ³⁸³ There is no evidence of an overarching national public health emergency response plan on the websites of the Ministry of Public Health and National Solidarity ³⁸⁴, the Ministry of Livestock and Animal Husbandry ³⁸⁵, the Ministry of the Environment and Fisheries ³⁸⁶ or the Ministry of Higher Education, Research, and Innovation ³⁸⁷. The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were inaccessible at the time of research.

Per WHO and World Bank information, Chad conducted a National Action Plan for Health Security (NAPHS) workshop in 2018, had a National Action Plan for Health Security (NAPHS) covering 2018-2021, and conducted another NAPHS workshop in 2024. ³⁸⁸³⁸⁹ Neither the 2018-2021 NAPHS nor any follow-up plan, however, is available through Chadian government websites or through the WHO. ^{390391392393394395} Chad has published a National Contingency Plan for the preparation and response to the epidemic of the Covid-19 coronavirus, where some NPIs ,such as social distancing, hand hygiene, cancellation of mass gatherings and the closure of schools, are mentioned. However, it does not include language that says the plan can be used for other diseases. ³⁹⁶

3.2.1a Completion of biological-focused IHR exercise with the WHO in past year

Score: 0

There is insufficient evidence that Chad has a national emergency response plan to activate or that it has completed a national-level biological threat-focused exercise (either with WHO or separately) in the past year. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Management of Health Emergencies” section that Chad must see to “the development of the multi-risk plan within the framework of One Health, the development of a COUSP human resources development plan and the provision of additional staff for public health emergency interventions” (p. 44); “The development of relevant standard operating procedures for the management of health emergencies” (p. 46) and “Developing a plan that identifies procedures and decision-making related to sending and receiving medical countermeasures during a public health emergency” (p. 46). ³⁹⁷ There is no evidence of an overarching national public health emergency response plan or a completed national-level biological threat-focused exercise in the past year on the websites of the Ministry of Public Health and National Solidarity ³⁹⁸, the Ministry of Livestock and Animal Husbandry ³⁹⁹, the Ministry of the Environment and Fisheries ⁴⁰⁰ or the Ministry of Higher Education, Research, and Innovation ⁴⁰¹. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

Per WHO and World Bank information, Chad conducted a National Action Plan for Health Security (NAPHS) workshop in 2018, had a National Action Plan for Health Security (NAPHS) covering 2018-2021, and conducted another NAPHS workshop in 2024. ⁴⁰²⁴⁰³ Neither the 2018-2021 NAPHS nor any follow-up plan, however, is available through Chadian government websites or through the WHO. ^{404405406407408409}

3.2.1b Evidence of bio-focused exercise to identify gaps/best practices

Score: 0

There is insufficient evidence that Chad has identified a list of gaps and best practices in response (either through an infectious disease response, after action review or a biological-threat focused exercise) and developed a plan to improve response capabilities in the past year. Chad completed its 2nd Joint External Evaluation (JEE) in 2023 ⁴¹⁰ but there is no evidence of a specific plan to respond to the identified gaps. ⁴¹¹ The 2024 National Strategy for the Promotion of Health and Well-Being 2024 – 2030 (Stratégie Nationale de Promotion de la Santé et du Bien Etre 2024 – 2030) (SNPSBE) does not include a specific plan to improve response capabilities. ⁴¹² Per WHO and World Bank information, Chad conducted a National Action Plan for Health Security (NAPHS) workshop in 2018, had a National Action Plan for Health Security (NAPHS) covering 2018-2021, and conducted another NAPHS workshop in 2024. ⁴¹³⁴¹⁴ Neither the 2018-2021 NAPHS nor any follow-up plan, however, is available through Chadian government websites or through the WHO. ^{415416417418419420} The WHO reports that Chad conducted an after action review in 2018 but does not list any completed since. ⁴²¹

3.2.2a Evidence of national-level biological threat-focused exercise that includes private sector

Score: 0

There is insufficient evidence that Chad has undergone a national-level biological threat-focused exercise that has included private sector representatives in the past year. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Management of Health Emergencies” section that Chad must see to “the development of the multi-risk plan within the framework of One Health, the development of a COUSP human resources development plan and the provision of additional staff for public health emergency interventions” (p. 44); “The development of relevant standard operating procedures for the management of health emergencies” (p. 46) and “Developing a plan that identifies procedures and decision-making related to sending and receiving medical countermeasures during a public health emergency” (p. 46). ⁴²² There is no evidence of a completed national-level biological threat-focused exercise in the past year on the websites of the Ministry of Public Health and National Solidarity ⁴²³, the Ministry of Livestock and Animal Husbandry ⁴²⁴, the Ministry of the Environment and Fisheries ⁴²⁵ or the Ministry of Higher Education, Research, and Innovation ⁴²⁶. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.) Neither the World Health Organization (WHO) ⁴²⁷ nor the WHO Regional Office for Africa ⁴²⁸ reports that Chad has completed a national-level biological threat-focused exercise in the past year.

3.3.1a Existence of Emergency Operations Center (EOC)

Score: 100

Chad has an Emergency Operations Center (EOC). The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Management of Health Emergencies” section that “the Public Health Emergency Operations Center (COUSP) was created by Order No. 178/PR/MSP/2019 of March 6, 2019, and operationalized by Order No.: 0118/PR/MSPSN/SE/DGM/DGTRIE/DRHF/SGP/2021 of July 2, 2021” (p. 44). Further, the JEE reports that “The country has normative documents (procedures manual, strategic plan, operational action plan) for the COUSP” and “The country has developed plans and procedures based on an incident management system” but that there is currently no dedicated budget for the EOC (p. 45). ⁴²⁹ A 2024 report from the Disease Outbreak News section of the World Health Organization (WHO) confirms that the EOC was activated in March of 2024 in response to a Hepatitis E outbreak in the eastern Ouaddai province of Chad. ⁴³⁰ Chad's Public Health Emergency Operations Center (Centre des Opérations d'Urgence en Santé Publique, COUSP) has in 2025 reported having "a five-year strategic plan, a procedures manual, concepts of operations, standard operating procedures [and] specific intervention plans for priority diseases", but none of these documents is available online, and the COUSP does not have a website. ⁴³¹⁴³²

3.3.1b Requirement for EOC to conduct/evidence EOC conducts at least annual drills

Score: 0

There is insufficient evidence that the Emergency Operations Center (EOC) in Chad is required to conduct a drill for a public health emergency scenario at least once per year or that they conduct a drill at least once per year. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Management of Health Emergencies” section that “the Public Health Emergency Operations Center (COUSP) was created by Order No. 178/PR/MSP/2019 of March 6, 2019, and operationalized by Order No.: 0118/PR/MSPSN/SE/DGM/DGTRIE/DRHF/SGP/2021 of July 2, 2021” (p. 44). ⁴³³ A July 2025 post on the Facebook page of the Ministry of Public Health and National Solidarity reports that “The Ministry of Public Health and Prevention, through its public health emergency operations center, has been organizing a workshop in Abeche since this morning on the implementation of a tabletop simulation exercise and drill: the case of the cholera epidemic. This workshop brings together participants from health delegations from Ennedi East, Ouaddaï, Sila, and Wadi Fira. The objective is to assess the response capacity of the Public Health Emergency Operations Center (COUSP) in the event of a cholera epidemic.” ⁴³⁴ While there is evidence of drills conducted, there is insufficient evidence that they are performed yearly; neither the World Health Organization (WHO) nor the WHO Regional Office for Africa reports that Chad regularly completes such exercises and the COUSP does not have a website. ⁴³⁵⁴³⁶

3.3.1c EOC activation within 120 minutes of identification of emergency/scenario

Score: 0

There is evidence that Chad’s Emergency Operations Center (EOC) has conducted, within the last year, a coordinated emergency response or emergency response exercise but not that it was activated within 120 minutes of the identification of the public health emergency/scenario. A 2024 report from the Disease Outbreak News section of the World Health Organization (WHO) confirms that the EOC was activated in March of 2024 in response to a Hepatitis E outbreak in the eastern Ouaddai province of Chad. However, the report does not confirm that the EOC was activated within 120 minutes of the public health emergency. ⁴³⁷ A July 2025 post on the Facebook page of the Ministry of Public Health and National Solidarity reports that “The Ministry of Public Health and Prevention, through its public health emergency operations center, has been organizing a workshop in Abeche since this morning on the implementation of a tabletop simulation exercise and drill: the case of the cholera epidemic. This workshop brings together participants from health delegations from Ennedi East, Ouaddaï, Sila, and Wadi Fira. The objective is to assess the response capacity of the Public Health Emergency Operations Center (COUSP) in the event of a cholera epidemic.” However, there was no evidence that the EOC was to be operational within 120 minutes. ⁴³⁸ Chad's Public Health Emergency Operations Center (Centre des Opérations d'Urgence en Santé Publique, COUSP) has in 2025 reported having "a five-year strategic plan, a procedures manual, concepts of operations, standard operating procedures [and] specific intervention plans for priority diseases", but none of these documents is available online, and the COUSP does not have a website. ⁴³⁹⁴⁴⁰

3.4.1a Joint exercise/procedures for potential deliberate biological events

Score: 0

There is insufficient evidence that public health, animal health, the private sector and national security authorities have carried out an exercise to respond to a potential deliberate biological event (i.e., bioterrorism attack) or that there is a publicly available standard operating procedures, guidelines, memorandums of understanding (MOUs), or other agreements between the public health, animal health, the private sector and security authorities to respond to a potential deliberate biological event. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Management of Health Emergencies” section that Chad must see to “the development of the multi-risk plan within the framework of One Health, the development of a COUSP human resources development plan and the provision of additional staff for public health emergency interventions” (p. 44); “The development of relevant standard operating procedures for the management of health emergencies” (p. 46) and “Developing a plan that identifies procedures and decision-making related to sending and receiving medical countermeasures during a public health emergency” (p. 46). ⁴⁴¹ A July 2025 post on the Facebook page of the Ministry of Public Health and National Solidarity reports that “The Ministry of Public Health and Prevention, through its public health emergency operations center, has been organizing a workshop in Abeche since this morning on the implementation of a tabletop simulation exercise and drill: the case of the cholera epidemic. This workshop brings together participants from health delegations from Ennedi East, Ouaddaï, Sila, and Wadi Fira. The objective is to assess the response capacity of the Public Health Emergency Operations Center (COUSP) in the event of a cholera epidemic.” However, the COUSP conducted a drill focused on responding to a potential deliberate biological event. ⁴⁴² Chad's Public Health Emergency Operations Center (Centre des Opérations d'Urgence en Santé Publique, COUSP) has in 2025 reported having "a five-year strategic plan, a procedures manual, concepts of operations, standard operating procedures [and] specific intervention plans for priority diseases", but none of these documents is available online, and the COUSP does not have a website. ⁴⁴³⁴⁴⁴

3.5.1a Risk communication plan for specific use during a public health emergency

Score: 100

There is evidence that Chad has a risk communication strategy document intended for use during a public health emergency. As part of the REDISSE IV Project, through the Economic Community of Central African States (ECCAS), Chad had developed a “Risk Communication Strategy Document” in 2021. ⁴⁴⁵ That document lays out the core principles of risk communication and community engagement and has chapters that cover “Approaches and Communication Techniques to be Preferred”, “Stakeholders in Communication”, “The Objectives of the Risk Communication Strategy”, “Communication Axes and Main Activities”, “Development Matrix of the Axes of the Communication Strategy” and “A System For Monitoring And Evaluating The Communication Strategy”. ⁴⁴⁶ The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Risk Communication and Collaboration with Communities” section that “there is no multisectoral risk communication coordination framework or national risk communication plan. However, the country does have a technical guide for integrated disease surveillance and response developed in 2021, which describes a risk communication and community engagement strategy” (p. 56). ⁴⁴⁷ A May 2o25 workshop held by the Center for Emergency Public Health Operations (COUSP) for media stakeholders highlighter their key role in communication during a health emergency. The workshop “aimed to raise awareness among them and seek their support in communication and advocacy, in order to facilitate the anticipation of sudden and often brutal health crises, for which Chad must be prepared. This day of discussions, marked by a clear desire for collective commitment, highlighted the fundamental role that the media can play in this system.” ⁴⁴⁸ There is no further relevant information on the websites of the Ministry of Public Health and National Solidarity ⁴⁴⁹, the Ministry of Livestock and Animal Husbandry ⁴⁵⁰, the Ministry of the Environment and Fisheries ⁴⁵¹ or the Ministry of Higher Education, Research, and Innovation ⁴⁵². (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

3.5.1b Inclusion of different population & sector needs in risk communication plan

Score: 100

There is evidence that Chad has a risk communication strategy document intended for use during a public health emergency that outlines how messages will reach populations and sectors with different communications needs. As part of the REDISSE IV Project, through the Economic Community of Central African States (ECCAS), Chad had developed a “Risk Communication Strategy Document” in 2021. ⁴⁵³ That document lays out the core principles of risk communication and community engagement and has chapters that cover “Approaches and Communication Techniques to be Preferred”, “Stakeholders in Communication”, “The Objectives of the Risk Communication Strategy”, “Communication Axes and Main Activities”, “Development Matrix of the Axes of the Communication Strategy” and “A System For Monitoring And Evaluating The Communication Strategy”. Specifically, “Strategic axis 3: development of mass communication with a view to informing and raising awareness among different REDISSE IV targets” covers the principles behind creating different media outreach to reach different target populations, including those with different languages (p. 11). ⁴⁵⁴ The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Risk Communication and Collaboration with Communities” section that “there is no multisectoral risk communication coordination framework or national risk communication plan. However, the country does have a technical guide for integrated disease surveillance and response developed in 2021, which describes a risk communication and community engagement strategy” (p. 56). ⁴⁵⁵ A May 2025 workshop held by the Center for Emergency Public Health Operations (COUSP) for media stakeholders highlighter their key role in communication during a health emergency. The workshop “aimed to raise awareness among them and seek their support in communication and advocacy, in order to facilitate the anticipation of sudden and often brutal health crises, for which Chad must be prepared. This day of discussions, marked by a clear desire for collective commitment, highlighted the fundamental role that the media can play in this system.” ⁴⁵⁶ There is no further relevant information on the websites of the Ministry of Public Health and National Solidarity ⁴⁵⁷, the Ministry of Livestock and Animal Husbandry ⁴⁵⁸, the Ministry of the Environment and Fisheries ⁴⁵⁹ or the Ministry of Higher Education, Research, and Innovation ⁴⁶⁰. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

3.5.1c Designation of a specific government spokesperson during a public health emergency

Score: 0

There is insufficient evidence that Chad has a risk communication strategy document that designates a specific position within the government to serve as the primary spokesperson to the public during a public health emergency. As part of the REDISSE IV Project, Chad had developed a “Risk Communication Strategy Document” in 2021. ⁴⁶¹ That document lays out the core principles of risk communication and community engagement and has chapters that cover “Approaches and Communication Techniques to be Preferred”, “Stakeholders in Communication”, “The Objectives of the Risk Communication Strategy”, “Communication Axes and Main Activities”, “Development Matrix of the Axes of the Communication Strategy” and “A System For Monitoring And Evaluating The Communication Strategy”. However, it does not specifically designate or encourage designating a specific position within the government to serve as the primary spokesperson to the public during a public health emergency. ⁴⁶² The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Risk Communication and Collaboration with Communities” section that “there is no multisectoral risk communication coordination framework or national risk communication plan. However, the country does have a technical guide for integrated disease surveillance and response developed in 2021, which describes a risk communication and community engagement strategy” (p. 56). ⁴⁶³ A May 2o25 workshop held by the Center for Emergency Public Health Operations (COUSP) for media stakeholders highlighter their key role in communication during a health emergency. The workshop “aimed to raise awareness among them and seek their support in communication and advocacy, in order to facilitate the anticipation of sudden and often brutal health crises, for which Chad must be prepared. This day of discussions, marked by a clear desire for collective commitment, highlighted the fundamental role that the media can play in this system.” ⁴⁶⁴ There is no further relevant information on the websites of the Ministry of Public Health and National Solidarity ⁴⁶⁵, the Ministry of Livestock and Animal Husbandry ⁴⁶⁶, the Ministry of the Environment and Fisheries ⁴⁶⁷ or the Ministry of Higher Education, Research, and Innovation ⁴⁶⁸. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

3.5.2a Government use of media platforms to share info on public health emergencies

Score: 100

There is evidence that the public health system has actively shared messages via online media platforms (e.g. social media, website) to inform the public about ongoing public health concerns and/or dispel rumors, misinformation or disinformation. The Facebook page of the Ministry of Public Health and National Solidarity regularly posts information and updates concerning public health matters. ⁴⁶⁹ Examples include an information and awareness-raising campaign covering breast and cervical cancers ⁴⁷⁰, an announcement concerning contaminated infant food ⁴⁷¹ and information about Cholera ⁴⁷².

3.5.2b Evidence that senior leaders have shared mis/disinformation on infectious diseases

Score: 100

There is insufficient evidence that senior leaders (president or ministers) have shared misinformation or disinformation on infectious diseases in the past two years. There is no evidence of such misinformation on the websites of the Presidency of the Republic of Chad ⁴⁷³, the Ministry of Public Health and National Solidarity ⁴⁷⁴, the Ministry of Livestock and Animal Husbandry ⁴⁷⁵, the Ministry of the Environment and Fisheries ⁴⁷⁶ or the Ministry of Higher Education, Research, and Innovation ⁴⁷⁷. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

3.6.1a Percentage of households with Internet

Score: 3.21

3.6.2a Mobile-cellular telephone subscriptions per 100 inhabitants

Score: 37.96

3.6.3a Gender gap in access to a mobile phone (percentage points)

Score: 0

3.6.4a Gender gap in access to the Internet (percentage points)

Score: 62.5

3.7.1a Restrictions on export/import of medical goods due to an infectious disease outbreak

Score: 100

There is no evidence that Chad has implemented restrictions on the export/import of medical goods due to an infectious disease outbreak in the past year. There is no evidence of such restrictions in the last year on the websites of the Ministry of Finance and Budget ⁴⁷⁸, the Ministry of Public Health and National Solidarity ⁴⁷⁹, the Ministry of Livestock and Animal Husbandry ⁴⁸⁰, the Ministry of the Environment and Fisheries ⁴⁸¹ or the Ministry of Higher Education, Research, and Innovation ⁴⁸². (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.) The World Trade Organization (WTO) does not list any such restrictions on its website. ⁴⁸³

3.7.1b Restrictions on movement and/or exports/imports due to disease outbreak

Score: 100

There is no evidence that Chad has implemented restrictions on the export/import of non-medical goods due to an infectious disease outbreak in the past year. There is no evidence of such restrictions in the last year on the websites of the Ministry of Finance and Budget ⁴⁸⁴, the Ministry of Public Health and National Solidarity ⁴⁸⁵, the Ministry of Livestock and Animal Husbandry ⁴⁸⁶, the Ministry of the Environment and Fisheries ⁴⁸⁷ or the Ministry of Higher Education, Research, and Innovation ⁴⁸⁸. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.) The World Trade Organization (WTO) does not list any such restrictions on its website. ⁴⁸⁹

3.7.2a Evidence of travel ban due to an infectious disease outbreak

Score: 100

There is no evidence that Chad has implemented inbound or outbound travel restrictions due to an infectious disease outbreak in the past year. There is no evidence of such restrictions in the last year on the websites of the Ministry of Finance and Budget ⁴⁹⁰, the Ministry of Public Health and National Solidarity ⁴⁹¹, the Ministry of Livestock and Animal Husbandry ⁴⁹², the Ministry of the Environment and Fisheries ⁴⁹³ or the Ministry of Higher Education, Research, and Innovation ⁴⁹⁴. (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.) The World Trade Organization (WTO) does not list any such restrictions on its website. ⁴⁹⁵ In August 2025, Chad suspended the issuance of visas to citizens of the United States of America but that was not due to an infectious disease outbreak. ⁴⁹⁶

3.7.2b Risk-based approach to international travel-related measures

Score: 0

There is insufficient evidence that Chad uses a risk-based approach to international travel-related measures. The 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” reports in the “Points of Entry and Border Health” section that “There are currently 18 officially designated PoEs in Chad. Health and community staff have been assigned to ensure the smooth running of these PoEs, although the sites lack veterinary, agricultural, and environmental staff, with the exception of Nguéli and Hassan Djamous International Airport in N'Djaména” and “Designated ports of entry do not have access to diagnostic facilities to quickly examine and treat sick travelers. These ports of entry do not provide adequate equipment and personnel to transport sick travelers to appropriate medical services. These ports of entry do not implement an inspection program to ensure the hygiene of services at the ports of entry or specific programs to control vectors and reservoirs” (p. 60). Further, “There is no national response plan to respond to public health emergencies occurring at points of entry” (p. 60). The JEE demonstrates that Chad lacks the infrastructure and plans to carry out a risk-based approach to international travel-related measures. The JEE includes in its recommendations that Chad “Develop a national multisectoral mechanism to apply a risk-based approach to the strategic management of international transport” (p. 62). ⁴⁹⁷ There is no evidence of a plan or strategy to use a risk-based approach to international travel-related measures on the websites of Ministry of Finance and Budget ⁴⁹⁸, the Ministry of Public Health and National Solidarity ⁴⁹⁹, the Ministry of Livestock and Animal Husbandry ⁵⁰⁰, the Ministry of the Environment and Fisheries ⁵⁰¹ or the Ministry of Higher Education, Research, and Innovation ⁵⁰². (The websites of the Ministry of Public Health and National Solidarity and the Ministry of Livestock and Animal Husbandry were unreachable during this research process.)

4.1.1a Doctors per 100,000 people

Score: 0.72

4.1.1b Nurses and midwives per 100,000 people

Score: 1.4

4.1.1c Updated health workforce strategy to address human resource shortfalls

Score: 0

Chad does not have a health workforce strategy in place which has been updated in the past five years.

The Ministry of Public Health had a Strategic Plan for the Development of Human Resources in Health (Plan Stratégique de Développement des Ressources Humaines pour la Santé, PSDRHS) 2011-2022, but it is outdated. ⁵⁰³ A WHO-funded National Action Planning for Health Security (NAPHS) activity titled "Revision of the Strategic Plan for the Development of Human Resources (PSDRHS)" received funding from 2018 until 2022. ⁵⁰⁴ No follow-up document to the 2011-2022 PSDRHS, however, was publicly available on the websites of the Ministry of Health and the Ministry of Public Service, Labor, and Employment, which were inaccessible at the time of research. ⁵⁰⁵⁵⁰⁶

The Ministry of Health's 2022-published National Health Development Plan (Plan National de Développement Sanitaire, PNDS) 2022-2030 includes a strategic focus on human resources in section 3.2.4.3 with relevant objectives, including the aim to evaluate and update the PSDRHS. ⁵⁰⁷ The PNDS does identify workforce insufficiences, which exist in many fields, and mention strategies such as increased recruitment, retainment incentives, improved training capacity and revised curricula. Overall, the PNDS notes "a lack of strategic management of human resources for health, weak capacity to develop policy and strategic documents on human resources in health, and inadequate implementation of mechanisms for accrediting and monitoring the curricula of public and private schools and faculties." ⁵⁰⁸ The PNDS section does not constitute a substantial health workforce strategy.

Key objective number 3 of Chad's World Bank-funded Regional Disease Surveillance Systems Enhancement (REDISSE IV) project was Public Health Workforce Development and aimed to "support the recruitment, training, and retention of qualified personnel for routine and emergency public health functions". ⁵⁰⁹ In 2021 a REDISSE IV Workforce Management Plan (WMP) was published by the Ministry of Health. ⁵¹⁰ Implementation of REDISSE IV in Chad, however, ended in July 2024. ⁵¹¹

4.1.1d Health system capacity for essential health services

Score: 0

Chad does not have sufficient capacity within the health system to deliver essential health services. According to the respective World Health Organization (WHO) indicators, Chad had 0.85 medical doctors per 10,000 population in 2023, and 1.67 Nursing and midwifery personnel per 10,000 population in the same year. ⁵¹²⁵¹³ A 2022 third-party summary of highest and lowest doctor density around the world shows Chad's 0.9 medical doctors per 10,000 population ranked the country among ten countries with the least doctors globally. ⁵¹⁴ The WHO's 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” observes in section R3 that use of health services in the country is very low, and apart from the existence of a routine health information system, district health information software and a mapping of health facilities, does not mention relevant strengths under its "use of health services" indicator. ⁵¹⁵ The 2024 IHR States Parties Self-Assessment of Chad also awards the lowest score of 20% under the indicator "C.9.3 Access to essential health services". ⁵¹⁶

The Ministry of Health's 2022-published National Health Development Plan (Plan National de Développement Sanitaire, PNDS) 2022-2030 in section 2.5.2.6 provides the following assessment of logistics and supply capaity: "Essential generic drugs (MEG) and other medical devices are not always available in departments. Frequent shortages of MEG in departments affect the quality of care. […] The Logistics Information and Management System (SIGL) is not yet effective, nor is the supply chain in the public and private sectors. Funds for the purchase of medicines are insufficient. Hospital pharmacies are not organized or functional in most hospitals, which often lack traceable medicines, medical devices, and specialty drugs for certain conditions (cancer, cardiovascular disease, neurology, etc.)." ⁵¹⁷

4.1.1e Essential health services continuity plan for public health emergencies

Score: 0

Chad does not have a plan to ensure continuity of essential health services during a public health emergency. The World Health Organization's (WHO) “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” states in section R3 that the country does not have such a plan nor any guidelines for the continuity of essential health services during a public health emergency. ⁵¹⁸ Per WHO and World Bank information, Chad had a National Action Plan for Health Security (NAPHS) covering 2018-2021, and conducted an NAPHS workshop in 2024. ⁵¹⁹⁵²⁰ Neither the 2018-2021 NAPHS nor any follow-up plan, however, is available through the Ministry of Health or through the WHO. ^521522523 Chad's Public Health Emergency Operations Center (Centre des Opérations d'Urgence en Santé Publique, COUSP) has in 2025 reported on its substantial human resource capacity, which suggests some capacity to ensure continuity of essential health services during an emergency, but the report does not mention a plan for ensuring this. ⁵²⁴

4.1.2a Hospital beds per 100,000 people

Score: 7.32

4.1.2b In-country capacity to isolate patients with highly communicable diseases

Score: 0

There is no evidence that Chad has capacity to isolate patients with highly communicable diseases in a biocontainment patient care unit and/or patient isolation room/unit located within the country. Chad had a National Contingency Plan for the preparation and response to the COVID-19 epidemic published in 2020 which mentioned the aimed for development of an isolation unit at the Hassan Djamous Airport. ⁵²⁵ A May 2020 World Bank review published under the project stated that "the Farcha Provincial hospital is being used as an isolation center for cases identified. Suspected cases identified in the regions will be isolated in District/Provincial hospitals. These sites will need to be renovated and equipped" (p.11). However, it also observed that "hospitals in Chad lack critical equipment to effectively respond to complications from COVID19. […] All suspected cases identified in Ndjamena will be kept at the Farcha Provincial hospital and others identified in provinces will be kept in provincial/district hospitals. However, isolation capacity at provincial and district hospitals will need to be developed" (p. 11). ⁵²⁶ Its baseline percentage of healthcare facilities with isolation capacity was 0% (p. 30). ⁵²⁷

The World Health Organization's 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” states in section R4 that Chad has a National Infection Prevention and Control Strategy 2023-2027, but it states that implementation at the level of health facilities is poor, and it does not observe capacity to isolate patients with highly communicable diseases in a biocontainment patient care unit and/or patient isolation room/unit. ⁵²⁸

4.1.2c Demonstrated capacity / evidence of plan to expand isolation capacity

Score: 0

There is no evidence that Chad has demonstrated capacity to expand isolation capacity in response to an infectious disease outbreak in the past two years or that it has developed, updated or tested a plan to expand isolation capacity in response to an infectious disease outbreak in the past two years. Chad's 2024 Seventy-seventh World Health Assembly declaration states that it has in 2022 published a National Infection Prevention and Control Strategy 2023-2027, and has set up a coordination team and a pool of trainers. ⁵²⁹ It admits, however, that the program "faces a shortage of resources for the implementation, the development of its monitoring and evaluation plan, and the decentralization of interventions to the community level." The document describes the response to various recent infectious disease outbreaks, but does not explicitly mention (testing or updating a plan for) expanding isolation capacity. The National Infection Prevention and Control Strategy 2023-2027 was published more than two years ago and is itself not publicly available. ⁵³⁰

The World Health Organization's 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” confirms in section R4 that regional implementation of the National Infection Prevention and Control Strategy 2023-2027 was insufficient. ⁵³¹ It does not mention that Chad has demonstrated capacity to expand isolation capacity in response to an infectious disease outbreak or that it has developed, updated or tested a plan to expand isolation capacity in response to an infectious disease outbreak.

4.2.1a National procurement protocol for the acquisition of routine laboratory/medical supplies

Score: 50

Chad has a national and international procurement protocol in place which can be utilized by the Ministries of Health and Agriculture for the acquisition of medical supplies (e.g. equipment, PPE) for routine needs, but there is no evidence that it has such a protocol or contract framework for laboratory supplies (e.g. equipment, reagents and media). The Ministry of Health's 2022-published National Health Development Plan (Plan National de Développement Sanitaire, PNDS) 2022-2030 in section 2.1.6 states that procurement of medicines and other medical products follows the Economic and Monetary Community of Central Africa's Common Pharmaceutical Policy (Politique Pharmaceutique Commune, PPC) as well as a national procedure which implements the PPC and which is titled "Procédure des Procédures". ⁵³² Procurement of medical supplies under the PPC is managed by Chad's Central Pharmaceutical Purchasing Agency (Centrale Pharmaceutique d’AChads, CPA). ⁵³³⁵³⁴

While laboratory supplies are included under "other medical products" in section 2.1.6 of the PNDS, the section does not mention a specific procurement protocol for them. Section 2.5.2.6, meanwhile, observes that "Reagents for analyses, especially in emergencies, are not sufficiently available in public hospitals", and the PDNS includes as an aim "Improving CPA governance through a more efficient procurement system for reagents and laboratory medical devices" with the expected outcome "A regulated, regular, sufficient, and timely supply of reagents and medical devices for the laboratory" (p. 220). ⁵³⁵ The World Health Organization's 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” in section D1 does not mention a national and/or international procurement protocol or contract framework for laboratory supplies, and recommends "The adoption of a national plan that takes into account the different levels of the healthcare pyramid and all areas of the IHR for the production and/or purchase, storage, and provision of the media and reagents necessary to perform basic laboratory tests." ⁵³⁶ There is no evidence on the CPA website of a procurement protocol or contract framework for laboratory supplies. ⁵³⁷ Chad's Directorate General of Pharmacy, Medicines and Laboratory (Direction Générale de la Pharmacie, du Médicament et Laboratoire, DGPML) does not have a website.

4.2.2a Stockpile of medical supplies for national use during a public health emergency

Score: 0

Chad does not have have a stockpile of medical supplies (e.g. MCMs, medicines, vaccines, medical equipment, PPE) for national use during a public health emergency defined by the overarching national public health emergency response plan, and there is no plan to ensure equitable distribution in an emergency. Section 2.1.6 of the Ministry of Health's 2022-published National Health Development Plan (Plan National de Développement Sanitaire, PNDS) 2022-2030 describes logistics and distribution systems and the roles of the National Commission for Coordination and Management of Medical Product Supplies and Stocks (Commission Nationale de Coordination et Gestion des Approvisionnements et stocks des Produits Médicaux, CNC-GASPM) and the Directorate General of Pharmacy, Medicines and Laboratory (Direction Générale de la Pharmacie, du Médicament et Laboratoire, DGPML). In section 2.5.2.6, however, the PNDS critically assesses medical supplies logistics as follows: "Essential generic drugs (MEG) and other medical devices are not always available in departments. Frequent shortages of MEG in departments [are] due to inadequate coordination of supplies. The Logistics Information and Management System (SIGL) is not yet effective, nor is the supply chain in the public and private sectors. Funds for the purchase of medicines are insufficient. Hospital pharmacies are not organized or functional in most hospitals, which often lack traceable medicines, medical devices, and specialty drugs for certain conditions (cancer, cardiovascular disease, neurology, etc.). Transport and storage conditions are inadequate at all levels of the distribution chain (CPA, PPA, FOSA), particularly in a context of difficult geographical accessibility (lack of suitable vehicles) and a lack of appropriate storage facilities." The PNDS does not mention a stockpile of medical supplies (e.g. MCMs, medicines, vaccines, medical equipment, PPE) for national use during a public health emergency nor a plan to ensure equitable distribution in an emergency. ⁵³⁸ The CNC-GASPM and DGPML do not have websites.

The World Health Organization's 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” in section R1 notes that Chad does not have a stockpile of MCMs for national use during a public health emergency. ⁵³⁹ In section P8 on vaccines it does not mention a stockpile of vaccines for national use during a public health emergency, and lists vaccine supply and distribution across the country as areas for further improvement (although the score of 3 for P8.2. indicates that vaccines are accessible and distributed throughout the country). ⁵⁴⁰ The websites of the Central Pharmaceutical Purchasing Agency (Centrale Pharmaceutique d’AChads, CPA) and Ministry of Health (inaccessible at the time of research) do not provide any further relevant information. ⁵⁴¹⁵⁴²

4.2.2b Stockpile of laboratory supplies for national use during a public health emergency

Score: 0

Chad does not have a stockpile of laboratory supplies (e.g. reagents, media) for national use during a public health emergency. The Ministry of Health's 2022-published National Health Development Plan (Plan National de Développement Sanitaire, PNDS) 2022-2030 in section 2.5.2.6 observes that "Reagents for analyses, especially in emergencies, are not sufficiently available in public hospitals", and it notes that there is no maintenance plan for laboratory equipment. ⁵⁴³ The PDNS includes as an aim "Improving [Central Pharmaceutical Purchasing Agency (Centrale Pharmaceutique d’AChads)] governance through a more efficient procurement system for reagents and laboratory medical devices" with the expected outcome of "A regulated, regular, sufficient, and timely supply of reagents and medical devices for the laboratory" (p. 220). The PNDS does not mention a stockpile of laboratory supplies (e.g. reagents, media) for national use during a public health emergency. ⁵⁴⁴

The World Health Organization's 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” recommends in section D1 "The adoption of a national plan that takes into account the different levels of the healthcare pyramid and all areas of the IHR for the production and/or purchase, storage, and provision of the media and reagents necessary to perform basic laboratory tests." ⁵⁴⁵

The websites of the Central Pharmaceutical Purchasing Agency (Centrale Pharmaceutique d’AChads, CPA) and Ministry of Health (inaccessible at the time of research) do not provide any further relevant information, and the Directorate General of Pharmacy, Medicines and Laboratory (Direction Générale de la Pharmacie, du Médicament et Laboratoire, DGPML) does not have a website. ⁵⁴⁶⁵⁴⁷

4.2.2c Annual review of national stockpile to ensure sufficient supply

Score: 0

Chad does not conduct or require an annual review of the national stockpile to ensure the supply is sufficient for a public health emergency. The Ministry of Health's 2022-published National Health Development Plan (Plan National de Développement Sanitaire, PNDS) 2022-2030 and the World Health Organization's 2024 “Joint external evaluation (JEE) of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” indicate that Chad does not have a stockpile for national use during a public health emergency. ⁵⁴⁸⁵⁴⁹ In section D1 the JEE states that Chad does not have a plan concerning the media and reagents necessary to perform basic laboratory tests; in section P8 on vaccines it does not mention a stockpile of vaccines; nowhere does the JEE mention an annual review of the national stockpile. ⁵⁵⁰

The websites of the Central Pharmaceutical Purchasing Agency (Centrale Pharmaceutique d’AChads, CPA) and Ministry of Health (inaccessible at the time of research) do not provide any further relevant information, and the Directorate General of Pharmacy, Medicines and Laboratory (Direction Générale de la Pharmacie, du Médicament et Laboratoire, DGPML) does not have a website. ⁵⁵¹⁵⁵² Chad's Public Health Emergency Operations Center (Centre des Opérations d'Urgence en Santé Publique, COUSP) has in 2025 reported having "a five-year strategic plan, a procedures manual, concepts of operations, standard operating procedures [and] specific intervention plans for priority diseases", but none of these documents is available online, and the COUSP does not have a website, allowing no confirmation of whether the COUSP conducts or requires an annual review of the national stockpile. ⁵⁵³⁵⁵⁴

4.2.3a Plan/agreement to produce/procure medical supplies during a public health emergency

Score: 0

There is no evidence of a plan/agreement to leverage public and/or private sector domestic (including regional) manufacturing capacity to produce medical supplies (e.g. MCMs, medicines, vaccines, equipment, PPE) for national use during a public health emergency; of a plan/mechanism to procure medical supplies; or of a plan/mechanism to expedite medical supplies through points of entry.

The World Health Organization's 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” in section R1.5 mentions that agreements with manufacturers or distributors to provide medical countermeasures in the event of a public health emergency exist, as well as regional or international agreements on the sharing of countermeasures. The agreements, however, are not named or listed with the supporting documents provided by the country. Overall, the indicator R1.5 is awarded the lowest score of 1, and it is recommended that Chad develops a plan that identifies procedures and decision-making related to the shipment and receipt of medical countermeasures during a public health emergency, and that it allocates resources and personnel dedicated to the logistics of delivering and receiving countermeasures. ⁵⁵⁵ In section P8 on vaccines it does not mention plans or mechanisms for producing, procuring, or expediting medical supplies, and lists vaccine supply and distribution across the country as areas for further improvement (although the score of 3 for P8.2. indicates that vaccines are accessible and distributed throughout the country). ⁵⁵⁶

The Ministry of Health's 2022-published National Health Development Plan (Plan National de Développement Sanitaire, PNDS) 2022-2030 in section 2.1.6 describes the country's general procurement framework, but does not mention a plan/mechanism to procure medical supplies for national use during a public health emergency. In section 2.5.2.6 it notes regarding medicines that "Local production is non-existent", and nowhere does it mention a plan/mechanism to expedite medical supplies through points of entry during an emergency situation. ⁵⁵⁷

Chad's Public Health Emergency Operations Center (Centre des Opérations d'Urgence en Santé Publique, COUSP) has in 2025 reported that it works based on "a five-year strategic plan, a procedures manual, concepts of operations, standard operating procedures (SOPs) [and] specific intervention plans for priority diseases", but it did not report a plan/agreement to produce or procure medical supplies or to expedite them through points of entry. ⁵⁵⁸ The websites of the Central Pharmaceutical Purchasing Agency (Centrale Pharmaceutique d’AChads, CPA) and Ministry of Health (inaccessible at the time of research) do not provide any further relevant information. ⁵⁵⁹⁵⁶⁰ The Directorate General of Pharmacy, Medicines and Laboratory (Direction Générale de la Pharmacie, du Médicament et Laboratoire, DGPML) does not have a website.

4.2.3b Plan/agreement to produce/procure lab supplies during a public health emergency

Score: 0

There is no evidence of a plan/agreement to leverage public and/or private sector domestic (including regional) manufacturing capacity to produce laboratory supplies (e.g. reagents, media) for national use during a public health emergency; of a plan/mechanism to procure laboratory supplies; or of a plan/mechanism to expedite laboratory supplies through points of entry. The World Health Organization's 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” in section D1 discusses the national laboratory system, but without mentioning a plan/agreement to leverage public and/or private sector domestic manufacturing capacity to produce laboratory supplies for national use during a public health emergency, or to procure such supplies, or to expedite them through points of entry. ⁵⁶¹ In D1.4 it recommends "The adoption of a national plan that takes into account the different levels of the healthcare pyramid and all areas of the IHR for the production and/or purchase, storage, and provision of the media and reagents necessary to perform basic laboratory tests." ⁵⁶² The websites of the Central Pharmaceutical Purchasing Agency (Centrale Pharmaceutique d’AChads, CPA) and Ministry of Health (inaccessible at the time of research) do not provide any further relevant information. ⁵⁶³⁵⁶⁴ The Directorate General of Pharmacy, Medicines and Laboratory (Direction Générale de la Pharmacie, du Médicament et Laboratoire, DGPML) does not have a website.

4.2.3c Mechanism emergency logistics and supply chain management

Score: 0

There is no evidence of a system or mechanism for national and subnational levels for emergency logistics and supply chain management. The World Health Organization's “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” in R1.5 awards Chad's logistics and supply chain management in emergency situations the lowest score of 1, and recommends that Chad develops a plan that identifies procedures and decision-making related to the shipment and receipt of medical countermeasures during a public health emergency, and that it allocates resources and personnel dedicated to the logistics of delivering and receiving countermeasures. ⁵⁶⁵

In section 2.5.2.6, the Ministry of Health's 2022-published National Health Development Plan (Plan National de Développement Sanitaire, PNDS) 2022-2030 critically assesses medical supplies logistics as follows: "Essential generic drugs (MEG) and other medical devices are not always available in departments. Frequent shortages of MEG in departments [are] due to inadequate coordination of supplies. The Logistics Information and Management System (SIGL) is not yet effective, nor is the supply chain in the public and private sectors. […] Transport and storage conditions are inadequate at all levels of the distribution chain (CPA, PPA, FOSA), particularly in a context of difficult geographical accessibility (lack of suitable vehicles) and a lack of appropriate storage facilities." The PNDS does not mention a system or mechanism for national and subnational levels for emergency logistics and supply chain management or reviewing or updating measures towards emergency logistics and supply chain management.

An April 2024 Ministry of Health announcement regarding a three-day training module for public and private pharmaceutical logistics stakeholders discusses improving reach and quality of the supply chain, but does not mention an emergency logistics and supply chain management system. ⁵⁶⁶ The websites of the Central Pharmaceutical Purchasing Agency (Centrale Pharmaceutique d’AChads, CPA) and Ministry of Health (inaccessible at the time of research) do not provide any further relevant information. ⁵⁶⁷⁵⁶⁸ The Directorate General of Pharmacy, Medicines and Laboratory (Direction Générale de la Pharmacie, du Médicament et Laboratoire, DGPML) does not have a website.

4.3.1a Plan/program/guidelines for dispensing MCMs during a public health emergency

Score: 0

Chad does not have a plan, program, or guidelines in place for dispensing medical countermeasures (MCMs) for national use during a public health emergency (i.e., antibiotics, vaccines, therapeutics and diagnostics). The World Health Organization's 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” in R1.5 awards Chad's logistics and supply chain management in emergency situations the lowest score of 1, and does not mention that it has a plan, program, or guidelines in place for dispensing MCMs for national use during a public health emergency. ⁵⁶⁹ Chad's Public Health Emergency Operations Center (Centre des Opérations d'Urgence en Santé Publique, COUSP) has in 2025 reported having "a five-year strategic plan, a procedures manual, concepts of operations, standard operating procedures [and] specific intervention plans for priority diseases", but none of these documents is available online, and the COUSP does not have a website, allowing no confirmation of whether the COUSP has a plan, program, or guidelines in place for dispensing MCMs. ⁵⁷⁰ The website of the Ministry of Health was inaccessible at the time of research; a version of the website archived in 2023 does not list information about the COUSP or about a plan, program, or guidelines in place for dispensing MCMs. ⁵⁷¹⁵⁷²

4.3.2a Plan to receive foreign health personnel during a public health emergency

Score: 0

Chad does not have a public plan in place to facilitate workforce surge in an emergency.

In 2023 the Ministry of Health reported having issued Decree No. 0054/PT/PM/MSPP/SE/SG/DGSP/COUSP/23, establishing a Rapid Intervention Group based on the World Health Organization (WHO) Strengthening and Utilizing Emergency Response Teams (SURGE) program. ⁵⁷³ While a September 2025 Ministry of Health announcement confirms that SURGE teams are deployed in Chad, the Decree is not publicly available, nor is any other plan to facilitate workforce surge in an emergency. ⁵⁷⁴⁵⁷⁵

Chad's Public Health Emergency Operations Center (Centre des Opérations d'Urgence en Santé Publique, COUSP) has in 2025 reported having 20 trained managers, rapid response teams deployed in 23 provinces and 10 priority districts, emergency medical teams composed of 26 managers, and the SURGE team, comprising 70 multisectoral and multidisciplinary managers. ⁵⁷⁶ It also reported working based on "a five-year strategic plan, a procedures manual, concepts of operations, standard operating procedures (SOPs) [and] specific intervention plans for priority diseases", but none of these documents is available online, and the COUSP does not have a website. ⁵⁷⁷⁵⁷⁸

The WHO's 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” discusses workforce surge in section D3 and R1, and does not mention a plan to facilitate this during an emergency. ⁵⁷⁹ In R1.4 it recommends developing a deployment and redeployment of surge personnel plan for public health emergency response. In D3.4 it recommends increasing [COUSP] staff and developing a national strategic plan for mobilizing multisectoral staff during emergencies. ⁵⁸⁰ In section R3 the JEE notes that the country does not have a plan or guidelines for the continuity of essential health services during a public health emergency.

Key objective number 3 of Chad's World Bank-funded Regional Disease Surveillance Systems Enhancement (REDISSE IV) project was Public Health Workforce Development, and aimed to "support the recruitment, training, and retention of qualified personnel for routine and emergency public health functions". ⁵⁸¹ In 2021 a REDISSE IV Workforce Management Plan (WMP) was published by Chad's Ministry of Health. ⁵⁸² Implementation of REDISSE IV in Chad, however, ended in July 2024. ⁵⁸³

4.3.2b Plan to facilitate workforce surge in an emergency

Score: 0

Chad does not have a public plan in place to receive health personnel from other countries to respond to a public health emergency. The World Health Organization's 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” discusses human resources during emergencies in section D3 and R1, and mentions regional/international personnel deployment agreements including participation in the WHO Global Outbreak Alert and Response Network (GOARN). It does not, however, list any government plan to receive health personnel from other countries to respond to a public health emergency. ⁵⁸⁴ The GOARN website lists Chad's Public Health Emergency Operations Center (COUSP) as a partner institution, and gives an example of a 2024 six-month GOARN support mission conducted by an epidemiologist after the July 2024 floods. The article on the support mission, however, does not mention any government plan which had guided the mission. ⁵⁸⁵

In 2023 the Ministry of Health reported having issued Decree No. 0054/PT/PM/MSPP/SE/SG/DGSP/COUSP/23, establishing a Rapid Intervention Group based on the World Health Organization (WHO) Strengthening and Utilizing Emergency Response Teams (SURGE) program. ⁵⁸⁶ While a September 2025 Ministry of Health announcement confirms that SURGE teams are deployed in Chad, the Decree is not publicly available, nor is any other plan to facilitate workforce surge in an emergency. ⁵⁸⁷⁵⁸⁸

4.3.2c Plan to redeploy existing health personnel within the country

Score: 0

Chad does not have a public plan in place to redeploy existing health personnel within the country. The World Health Organization's 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” discusses human resources during emergencies in section D3 and R1, and does not mention a plan to redeploy existing health personnel within the country. In R1.4 it recommends developing a deployment and redeployment of surge personnel plan for public health emergency response. ⁵⁸⁹

A 2023 announcement published by Chad's Public Health Emergency Operations Center (Centre des Opérations d'Urgence en Santé Publique, COUSP) mentions Decree No. 0054/PT/PM/MSPP/SE/SG/DGSP/COUSP/23, establishing a Rapid Intervention Group based on the World Health Organization (WHO) Strengthening and Utilizing Emergency Response Teams (SURGE) program, but does not mention a plan to redeploy existing health personnel, and the Decree is not publicly available. ⁵⁹⁰⁵⁹¹

Key objective number 3 of the World Bank-funded Regional Disease Surveillance Systems Enhancement (REDISSE IV) project was Public Health Workforce Development and aimed to "support the recruitment, training, and retention of qualified personnel for routine and emergency public health functions". ⁵⁹² In 2021 a REDISSE IV Workforce Management Plan (WMP) was published by Chad's Ministry of Health. ⁵⁹³ Implementation of REDISSE IV in Chad, however, ended in July 2024. ⁵⁹⁴

4.4.1a Constitutional guarantee of citizens’ right to medical care

Score: 0

The Constitution does not guarantee citizens’ right to medical care. Chad's Constitution was last revised in October 2025, however the full text of these amendments is not available on the website of the Presidency of the Republic of Chad or on the government's information portal. ⁵⁹⁵⁵⁹⁶ The 2023 Constitution, as prior to these amendments, does not include a guaranteed right to medical care: Chapter 1 on basic rights does not include a right to health, and only mentions a right to a healthy environment, in article 51. Article 132 mentions public health only as a sector under the legislature, without providing any detail on (a right to, or the provision of) medical care. ⁵⁹⁷

4.4.1b Access to skilled birth attendants (% of population)

Score: 22.06

4.4.1c Out-of-pocket health expenditures per capita, PPP (current international $)

Score: 93.11

4.4.1d Coverage of essential health services through universal health coverage

Score: 4.17

4.4.1e Total population pushed below a relative poverty line by household health expenditure (60% of media daily per capita consumption or income)

Score: 66.14

4.4.1f Rate of mortality amenable to health care

Score: 87.05

4.4.2a Guaranteed paid sick leave

Score: 66.67

Guaranteed paid sick leave exists in Chad. The Chadian Labor Code (Loi n° 038/PR/96 du 11 décembre 1996 portant Code du travail) states in section II of Chapter III that up to 6 months of sick leave are guaranteed when a medical certificate is provided. ⁵⁹⁸⁵⁹⁹ Sick leave payments depend on length of seniority, but 1 month of salary is guaranteed. ⁶⁰⁰ The Labor code does not specify if the leave is available for mental health problems, and the lack of dedicated legislation and infrastructure for mental health services, as observed by a 2025 report published by the NGO Right for Education Foundation, suggests that there exists no guarantee that a relevant medical certificate could be obtained. ⁶⁰¹⁶⁰²

4.4.3a Government prioritisation of care for healthcare workers during response

Score: 0

There is no evidence that the Chadian government has issued legislation, a policy, or a public statement committing to provide prioritized healthcare services to healthcare workers who become sick as a result of responding to a public health emergency. The Ministry of Health's 2022-published National Health Development Plan (Plan National de Développement Sanitaire, PNDS) 2022-2030 includes a strategic focus on human resources in section 3.2.4.3, but it does not discuss provision of prioritized healthcare services to healthcare workers who become sick during work. ⁶⁰³ The World Health Organization's “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” does not mention any legislation, policy, or public statement committing to provide prioritized healthcare services to healthcare workers who become sick as a result of responding to a public health emergency. ⁶⁰⁴

A 2021 Regional Disease Surveillance Systems Enhancement (REDISSE IV) Workforce Management Plan (WMP) published by the Ministry of Health discusses occupational health of healthcare workers responding to Chad's Covid-19 epidemic. ⁶⁰⁵ The document mentions disease prevention and control measures for treatment centers from page 29, but no prioritized healthcare services for sick healthcare workers are listed. Implementation of the REDISSE IV project in Chad ended in July 2024. ⁶⁰⁶

4.5.1a Existence of system for communication during a public health emergency

Score: 100

There is evidence of a system in place for public health officials and healthcare workers to communicate during a public health emergency. Chad's Public Health Emergency Operations Center (Centre des Opérations d'Urgence en Santé Publique, COUSP) has in 2025 reported having 20 trained managers, rapid response teams deployed in 23 provinces and 10 priority districts, and SURGE team comprising 70 multisectoral and multidisciplinary managers. ⁶⁰⁷ It also reported working based on "a five-year strategic plan, a procedures manual, concepts of operations, standard operating procedures (SOPs) [and] specific intervention plans for priority diseases"; none of these documents is available online, and the COUSP does not have a website. ⁶⁰⁸⁶⁰⁹

Among the aims of a July 2024 COUSP simulation was to "familiarize COUSP staff with existing telecommunication and information systems" and to test "the COUSP's ability to manage operational and public health event information for decision-making, the capabilities and skills of the COUSP to coordinate the actions of other responders and collaborate with them during health events or threats, [and] the procedures for collaboration between COUSPs and national disaster management authorities and other key sectors". ⁶¹⁰ This indicates that through the COUSP, a system is in place for public health officials and healthcare workers to communicate during a public health emergency. Inaugurating the COUSP's new premises in February 2025, furthermore, the COUSP coordinator stated that "This new space will provide a scientific framework for optimizing epidemiological surveillance and coordinating health measures", particularly between sectoral ministries. ⁶¹¹

4.5.1b Inclusion of public and private sector in healthcare communication system

Score: 0

There is no evidence of a system for public health officials and healthcare workers to communicate during a public health emergency which encompasses healthcare workers in both the public and private sector. Chad's Public Health Emergency Operations Center (Centre des Opérations d'Urgence en Santé Publique, COUSP) has in 2025 reported having 20 trained managers, rapid response teams deployed in 23 provinces and 10 priority districts, and SURGE team comprising 70 multisectoral and multidisciplinary managers. ⁶¹² It also reported working based on "a five-year strategic plan, a procedures manual, concepts of operations, standard operating procedures (SOPs) [and] specific intervention plans for priority diseases", but none of these documents is available online, and the COUSP does not have a website. ⁶¹³⁶¹⁴

Among the aims of a July 2024 COUSP simulation was to "familiarize COUSP staff with existing telecommunication and information systems" and to test "the COUSP's ability to manage operational and public health event information for decision-making, the capabilities and skills of the COUSP to coordinate the actions of other responders and collaborate with them during health events or threats, [and] the procedures for collaboration between COUSPs and national disaster management authorities and other key sectors". ⁶¹⁵ While this indicates that through the COUSP, a system is in place for public health officials and healthcare workers to communicate during a public health emergency, the report on the simulation does not mention whether it encompasses healthcare workers in both the public and private sector, and the website of the Ministry of Public Health does not provide further information on the COUSP communication system. ⁶¹⁶

4.6.1a Evidence of national public health system monitoring and tracking of HCAIs

Score: 0

There is no evidence that the national public health system is monitoring for and tracking the number of healthcare associated infections (HCAI) that take place in healthcare facilities. The WHO “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” in section R4.2 recommends setting up such a surveillance system and developing a HCAI plan. ⁶¹⁷ The section does mention that a HCAI committee exists, as well as "weekly transmission of data on diseases under surveillance", but Chad still received the lowest score of 1 under the "Monitoring of hospital-acquired infections" indicator. Chad's 2024 Seventy-seventh World Health Assembly declaration states that it has in 2022 published a National Infection Prevention and Control Strategy 2023-2027, and has set up a coordination team. ⁶¹⁸ It admits, however, that the program "faces a shortage of resources for the implementation, the development of its monitoring and evaluation plan, and the decentralization of interventions to the community level." ⁶¹⁹ No further relevant information was identified through the Ministry of Public Health. ⁶²⁰

4.6.1b Infection prevention and control programme

Score: 0

Chad has an infection prevention and control (IPC) programme in place but it is not publicly available. Chad's 2024 Seventy-seventh World Health Assembly declaration states that it has in 2022 published a National Infection Prevention and Control Strategy 2023-2027, and has set up a coordination team and a pool of trainers. ⁶²¹ It admits, however, that the program "faces a shortage of resources for the implementation, the development of its monitoring and evaluation plan, and the decentralization of interventions to the community level." The National Infection Prevention and Control Strategy 2023-2027 document is itself not available online. ⁶²² The World Health Organization's 2024 “Joint external evaluation (JEE) of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” in section R4.3 mentions standards, guidelines, and procedures for ensuring a safe environment in health facilities, but it observes lacking integration of IPC/WASH indicators into the health information system and inoperational IPC committees. The JEE does not mention an active IPC plan. ⁶²³

4.6.1c National plan to ensure a safe environment in health facilities

Score: 0

There is no evidence of a plan to ensure a safe environment in health facilities nationally. The WHO “Joint external evaluation (JEE) of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” in section R4.3 mentions standards, guidelines, and procedures for ensuring a safe environment, as well as a guide for biomedical waste management. However, it observes a lack of trained sanitary engineering technicians and no structured program for their training, insufficient PPE availability, lacking integration of IPC/WASH indicators into the health information system, and inoperational IPC committees. The JEE does not mention a plan to ensure a safe environment in health facilities nationally. ⁶²⁴

Chad's 2024 Seventy-seventh World Health Assembly declaration states that it has in 2022 published a National Infection Prevention and Control Strategy 2023-2027, and has set up a coordination team and a pool of trainers. ⁶²⁵ It admits, however, that the program "faces a shortage of resources for the implementation, the development of its monitoring and evaluation plan, and the decentralization of interventions to the community level." The National Infection Prevention and Control Strategy 2023-2027 document is itself not available online and no further relevant information was identified through the Ministry of Public Health. ⁶²⁶

4.7.1a Requirement for ethical review before beginning a clinical trial

Score: 0

There is no evidence of a national requirement for ethical review (e.g., from an ethics committee or via Institutional Review Board approval) before beginning a clinical trial.

Chad has a National Bioethics Committee (Comité National de Bioéthique du Tchad, CNBT) established in 2010. ⁶²⁷ A 2024 announcement published by the Ministry of Higher Education discusses a workshop on new regulatory supplements from Training and Resources in Research Ethics Evaluation together with participants from South Africa, West Africa, Cameroon and Chad. The announcement recapitulates that the CNBT was established by order of the Minister of Higher Education and that its aim is to "warn the population against harmful practices and experiments" including clinical trials, epidemiological research, social science research, and research on medical records. ⁶²⁸ This does not evidence a national requirement for ethical review, however, which the article does not mention.

During a February 2024 Cameroon Bioethics Initiative seminar, the CNBT chairperson stated that CHAD has ratified the relevant UNESCO conventions, namely Universal Declaration on the Human Genome and Human Rights (1997), International declaration on human genetic data (2003), and the Universal Declaration on Bioethics and Human Rights (2005), that a key aim of the CNBT is to "Provide advice to decision-makers on ethical, legal, scientific and social issues relating to research projects research involving human beings", and that it meets 4 times per year. He also stated, however, that Chad does not have a law on bioethics, and did not mention a national requirement for ethical review. ⁶²⁹

A 2017 article on the functioning of the CNBT only mentioned it having reviewed protocols submitted by NGOs, no clinical trials. ⁶³⁰ The CNBT does not have a website and no further relevant evidence was found through the Ministry of Health and the Ministry of Higher Education. ⁶³¹⁶³²

4.7.1b Expedited approval for clinical trials of unregistered MCMs during epidemics

Score: 0

There is no evidence of an expedited process for approving clinical trials for unregistered medical countermeasures (MCM) or mutual recognition of clinical trial results taking place elsewhere to treat ongoing pandemics or epidemics. No information about an expedited process for approving clinical trials for unregistered medical countermeasures (MCM) or mutual recognition of clinical trial results taking place elsewhere is available through the Ministry of Health and the Ministry of Higher Education, and Chad's National Drug Commission does not have a website. ⁶³³⁶³⁴ Per WHO and World Bank information, Chad had a National Action Plan for Health Security (NAPHS) covering 2018-2021, and conducted an NAPHS workshop in 2024. ⁶³⁵⁶³⁶ Neither the 2018-2021 NAPHS nor any follow-up plan, however, is available through the Ministry of Health or through the WHO. ^637638639

4.7.2a Existence of agency responsible for approving new human MCMs

Score: 100

There is publicly available evidence that Chad has a government agency responsible for approving new medical countermeasures for humans. Chad's National Drug Commission is responsible for approving new medical countermeasures for humans. ⁶⁴⁰ Per Law 024/PR/2000 of 24 November 2000 On Pharmacy, it has 6 months from the date of deposit to evaluate a new request for medical countermeasure. ⁶⁴¹ In 2021 the World Health Organizations reported having supported the "development of a stronger regulatory framework for the pharmaceutical industry" in Chad, but no information about the framework is available through the Ministry of Health, and the National Drug Commission does not have a website. ⁶⁴²⁶⁴³

4.7.2b Expedited approval for human MCMs during public health emergencies

Score: 0

There is no evidence of an expedited process for approving medical countermeasures (MCM) for human use or recognition of approval decisions taking place elsewhere during public health emergencies. Neither is mentioned in Chad's Law 024/PR/2000 of 24 November 2000 On Pharmacy, and no relevant information is available through the Ministry of Health and the Ministry of Higher Education. ^644645646 Chad's National Drug Commission does not have a website.

Per WHO and World Bank information, Chad had a National Action Plan for Health Security (NAPHS) covering 2018-2021, and conducted an NAPHS workshop in 2024. ⁶⁴⁷⁶⁴⁸ Neither the 2018-2021 NAPHS nor any follow-up plan, however, is available through the Ministry of Health or through the WHO. ^649650651

5.1.1a Submission of IHR reports to the WHO in past year

Score: 100

Chad has submitted an IHR Self-Assessment Annual Report (SPAR) to the WHO for the last calendar year, with the latest submission in 2024.⁶⁵²

5.1.2a Existence of specific risk reduction strategies for epidemics and pandemics

Score: 0

There is no evidence of a national risk reduction strategy or a standalone national disaster risk reduction strategy for epidemics and pandemics. An October 2022 review published by the African Union and international partners noted that "Chad is developing a DRR strategy that will be aligned with the Sendai Framework. A technical validation process was undertaken in December 2020 (Civil Protection interview, 2021), although the timeframe for further development has been difficult to ascertain" (p. 60). The review does not mention that epidemics and pandemics are or will be integrated into government risk reduction strategy documents or initiatives. ⁶⁵³ The World Health Organization's “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” in section R1.1 mentions a Strategic Tool for Assessing Risks exercise which was conducted in 2023, but it does not mention a national risk reduction strategy or a standalone national disaster risk reduction strategy for epidemics and pandemics; instead it recommends the development of a multi-risk plan. ⁶⁵⁴ The websites of the Ministry of Health and the Ministry of Territorial Administration, Decentralization, and Good Governance were inaccessible at the time of research, and the General Directorate of Civil Protection (Direction générale de la protection civile) does not have a website. ⁶⁵⁵⁶⁵⁶

5.2.1a Existence of public health emergency agreements with regional neighbors

Score: 100

Chad has cross-border agreements, protocols, or MOUs with neighboring countries as part of regional initiatives with regards to public health emergencies and there is evidence that they are actively implemented.

Chad is a part of the Lake Chad Basin Polio Eradication Plan 2024-2025, which involves Cameroon, Nigeria, Niger, Chad, and the Central African Republic, focusing on synchronizing vaccination campaigns, sharing data, and implementing interventions for mobile and cross-border populations. ⁶⁵⁷ As of 2025 there was early evidence that the establishment of real-time data-sharing mechanisms under the project had started. ⁶⁵⁸ In April 2025 Cameroon, Chad, Niger, and Nigeria cooperated on a joint polio vaccination campaign. ⁶⁵⁹ Polio retains its status as a Public Health Emergency of International Concern (PHEIC) as of November 2025.⁶⁶⁰

In 2025 a Ministry of Health official stated "We have a synchronized platform for exchanging information with neighboring countries. Collaboration is particularly good with the countries of the Central African Economic and Monetary Community (CEMAC), even if the network and interference sometimes limit us." ⁶⁶¹ There is no evidence on the websites of the CEMAC or of its Organization for the Coordination of Endemic Disease Control in Central Africa (OCEAC), however, showing implementation of this platform or of other cross-border agreements, protocols, or MOUs regarding health emergencies. ⁶⁶²⁶⁶³

5.2.1b Existence of animal health emergency agreements with regional neighbors

Score: 0

There is no evidence that Chad has cross-border agreements, protocols, or MOUs as part of a regional group with regards to animal health emergencies.

The African Union Inter-African Bureau for Animal Resources's (AU-IBAR) Animal Health Strategy for Africa 2019-2035 includes the goal of promoting the establishment of early warning, emergency response mechanisms and disaster fund for animal resources at national, regional and continental levels. ⁶⁶⁴ In 2025 Chad has participated in training provided by AU-IBAR under the Regional Program for the Control of Transboundary Animal Diseases in Africa, but no further evidence of national implementation of this programme or other AU-IBAR policies was found in Chadian and international media. ⁶⁶⁵

No other cross-border agreements, protocols, or MOUs as part of a regional group with regards to animal health emergencies were found; the websites of the Ministries of Agriculture and of Health were inaccessible at the time of research. ⁶⁶⁶⁶⁶⁷

5.3.1a Biological and Toxin Weapons Convention status

Score: 0

Chad does not have signatory status to the Biological Weapons Convention. ⁶⁶⁸

5.3.1b Submission of CBMs to the Biological and Toxin Weapons Convention

Score: 0

Chad has not submitted confidence building measures for the Biological Weapons Convention. ⁶⁶⁹

5.3.1c Submission of UNSCR 1540 reports

Score: 0

Chad has not provided the required United Nations Security Council Resolution (UNSCR) 1540 report to the Security Council Committee established pursuant to resolution 1540 (1540 Committee). ⁶⁷⁰

5.3.1d Extent of UNSCR 1540 implementation on public health emergencies

Score: 0

5.3.2a Membership in global health security and/or biological weapons agreements

Score: 0

Chad is not listed as a member of the Proliferation Security Initiative (PSI), the Global Partnership Against the Spread of Weapons and Materials of Mass Destruction (GP), or the Australia Group (AG). ^671672673

5.4.1a Completion and publication of JEE (or GHSA pilot external assessment) report

Score: 100

Chad has completed a Joint External Evaluation (JEE) and published a full report in the last five years. Chad completed a Joint External Evaluation (JEE) in 2023; the full report is available on the website of the World Health Organization (WHO). ⁶⁷⁴

5.4.2a Completion and publication of PVS report (past five years)

Score: 0

There is insufficient evidence that Chad has completed and published a Performance of Veterinary Services (PVS) assessment in the last five years. According to the World Organization for Animal Health (WOAH), Chad has performed the following assessments: PVS Evaluation (initial) 2008; PVS Evaluation (follow-up) 2019; PVS Gap-Analysis 2014; PVS Gap-Analysis (update) 2017; and PVS Legislation 2016. ⁶⁷⁵

5.4.2b Completion and publication of PVS gap analysis (past five years)

Score: 0

There is insufficient evidence that Chad has completed and published a Performance of Veterinary Services (PVS) gap analysis in the last five years. According to the World Organization for Animal Health (WOAH), Chad has performed the following assessments: PVS Evaluation (initial) 2008; PVS Evaluation (follow-up) 2019; PVS Gap-Analysis 2014; PVS Gap-Analysis (update) 2017; and PVS Legislation 2016. ⁶⁷⁶

5.5.1a Evidence of allocated national funds to improve capacity to address epidemic threats

Score: 100

There is evidence that Chad allocates national funds to improve capacity to address pandemic or epidemic threats. Chad's "Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023" in section P2.2 states that annual budget lines exist for management of epidemics, for medicines, and for a planned emergency hotline. ⁶⁷⁷ In section P8 it states that vaccine and consumables procurement relies on 20% state funding and on the Vaccine Alliance for the other 80%.

5.5.2a National budget to address gaps identified in JEE, NAPHS or GHSA roadmap

Score: 100

The Joint External Evaluation (JEE) report does describe specific funding from the national budget (covering a time-period either in the future or within the past five years) to address the identified gaps; Chad does not have an active National Action Plan for Health Security (NAPHS). Chad's 2024 "Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023" in section P2.2 states that annual budget lines exist for management of epidemics, for medicines, and for a planned emergency hotline. In its conclusion, the JEE lists all 19 technical areas as areas for improvement, implying that the listed items, for which budget lines exist, were identified as gaps. ⁶⁷⁸ Otherwise, however, section P2 criticizes that funding of IHR activities is drawn from the annual budgets of sectoral ministries, which present their budget proposals in interministerial budget meetings (as opposed to a dedicated budget line for IHR activities across ministries). ⁶⁷⁹

Per World Health Organization and World Bank information, Chad had a National Action Plan for Health Security (NAPHS) covering 2018-2021, and conducted an NAPHS workshop in 2024. ⁶⁸⁰⁶⁸¹ Neither the 2018-2021 NAPHS nor any follow-up plan, however, is available through the Ministry of Health or through the WHO. ^682683684

5.5.2b National budget to address gaps identified in PVS assessment or gap analysis

Score: 0

Chad has not conducted a Performance of Veterinary Services (PVS) gap analysis and/or PVS assessment in the last five years. According to the World Organization for Animal Health (WOAH), Chad has performed the following assessments: PVS Evaluation (initial) 2008; PVS Evaluation (follow-up) 2019; PVS Gap-Analysis 2014; PVS Gap-Analysis (update) 2017; and PVS Legislation 2016. ⁶⁸⁵

5.5.3a Emergency public financing during a public health emergency

Score: 100

There is publicly available evidence that there is a publicly identified special emergency public financing mechanism and funds which the country can access in the face of a public health emergency. An established agreement is in place with the World Bank pandemic financing facility, that enables Chad to receive IDA resources. ⁶⁸⁶⁶⁸⁷ According to the 2017 WAHO PVS Gap Analysis, Chad has a post-emergency fund to support the victims of a disaster. ⁶⁸⁸ The World Bank's Regional Disease Surveillance Systems Enhancement Project (REDISSE) Phase IV, implemented in Chad from 2020 until 2024, listed as one of its two objectives "in the event of an Eligible Crisis or Emergency, to provide immediate and effective response to said Eligible Crisis or Emergency." ⁶⁸⁹

5.5.4a Commitments to improve domestic or foreign capacity for epidemic threats

Score: 0

There is no evidence that Chadian senior leaders have made a public commitment either to support other countries to improve capacity to address pandemic or epidemic threats by providing financing or support, or to improve the country’s domestic capacity to address pandemic or epidemic threats by expanding financing or requesting support to improve capacity. No relevant evidence was found on the website of the Presidency of the Republic of Chad or on the government's information portal. ⁶⁹⁰⁶⁹¹ The website of the Ministry of Health was inaccessible at the time of research. ⁶⁹² No relevant statements were identified in Chadian or international media reports.

In his foreword to the WHO Cooperation Strategy with Chad 2024–2027, Chad's Minister of Health stated that "WHO support also helps to mobilize other technical and financial partners", but no commitment to requesting support (from the WHO or from other partners) is included in the Strategy. ⁶⁹³ After the death of 30-year president Idriss Déby Itno during a military offensive in Northern Chad, Chad was from April 2021 until February 2025 governed by a military transitional government. ⁶⁹⁴

5.5.4b Investments to improve domestic or foreign capacity for epidemic threats

Score: 100

There is no evidence that Chad has provided other countries with financing or technical support to improve capacity to address epidemic threats, but there is evidence that it has requested financing or technical support from donors to improve the country’s domestic capacity to address epidemic threats. In 2025 the Minister of Health stated that among ten priority projects of the President was the inauguration of the Public Health Emergency Operations Center (Centre des Opérations d'Urgence en Santé Publique, COUSP), and that for the project, the country relied entirely on World Bank financial support. ⁶⁹⁵ A 2023 WHO report on Chad's Dengue outbreak response stated that "The Ministry of Public Health and Prevention has […] with the support of WHO and other partners [mobilized] resources for the implementation of the national contingency plan for dengue preparedness and response, developed with WHO assistance." ⁶⁹⁶ No evidence was identified in Chadian or international media that Chad provided other countries with financing or technical support to improve capacity to address epidemic threats.

5.5.4c Evidence that the country has fulfilled its full WHO contribution within the past two years

Score: 100

Chad has fulfilled its full contribution to the WHO within the past two years. The WHO’s Statement of Account for Chad as at 31 January 2025 shows that the country has paid its contribution for the years 2022 through 2025. ⁶⁹⁷

5.6.1a Sharing of genetic/biological data and materials beyond influenza

Score: 0

Chad does not have a publicly available plan or policy for sharing genetic data, clinical specimens, and/or isolated specimens (biological materials) along with the associated epidemiological data with international organizations and/or other countries that goes beyond influenza. The World Health Organization (WHO) "Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023" in section D2 states that surveillance data is shared with the WHO, but it does not mention if this includes genetic data, clinical specimens, and/or isolated specimens, nor does it mention a plan or policy for sharing data. ⁶⁹⁸ There is no further evidence available through the Ministry of Health website, which was inaccessible at the time of research, or through the website of Chad's National Reference University Hospital Center. ^699700701

5.6.1b Evidence of non-compliance with sample sharing element of PIP framework

Score: 100

There is no public evidence that the country has not shared samples in accordance with the Pandemic Influenza Preparedness (PIP) framework in the past two years. According to the World Health Organization's (WHO) 2024 “Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of Chad: Mission report, 24-28 July 2023” and a 2020 WHO report titled "Chad starts influenza surveillance and reporting to FluNet with the support of the PIP Partnership Contribution", Chad has sentinel influenza surveillance sites and has trained laboratory technicians in the safe shipment of infectious materials. ⁷⁰²⁷⁰³ In 2019 Chad submitted its first report to FluNet, and since, no evidence was identified in Chadian or international media or through WHO reporting that the country has not shared samples in accordance with the PIP framework. ⁷⁰⁴⁷⁰⁵

Per the WHO Influenza Virus Traceability Mechanism (IVTM) webpage, Chad does not have a National Influenza Center. ⁷⁰⁶

5.6.1c Evidence of non-sharing of pandemic pathogen samples during an outbreak

Score: 100

There is no evidence that Chad has not shared pandemic pathogen samples during an outbreak in the past two years. A 2024 World Health Organization report shows that Chad shared samples during a 2024 Hepititus E outbreak, and a 2023 WHO report on a dengue outbreak does not mention that the country did not share samples. ⁷⁰⁷⁷⁰⁸ No evidence was identified in Chadian or international media that the country has not shared pandemic pathogen samples during an outbreak in the past two years.

6.1.1a Policy formation

Score: 25

6.1.1b Quality of bureaucracy

Score: 0

6.1.1c Excessive bureaucracy/red tape

Score: 0

6.1.1d Vested interests/cronyism

Score: 0

6.1.1e Corruption

Score: 21

6.1.1f Accountability of public officials

Score: 25

6.1.1g Human rights risk

Score: 0

6.1.2a Orderly transfers of power

Score: 0

6.1.3a Risk of social unrest

Score: 25

6.1.4a Risk of terrorism

Score: 0

6.1.4b Level of illicit arms flows within the country

Score: 50

6.1.4c Risk of organized criminal activity

Score: 25

6.1.5a Presence or risk of armed conflict

Score: 25

6.1.6a Government territorial control

Score: 0

6.1.7a International tensions

Score: 25

6.2.1a Adult literacy rate (15+ years old, both sexes)

Score: 32.16

6.2.2a UNDP Gender Inequality Index score

Score: 1.59

6.2.3a Poverty gap at $1.90 a day (2011 PPP) (%)

Score: 50.57

6.2.3b Share of employment in the informal sector

Score: 0

6.2.3c Coverage of social insurance programs (% of population)

Score: 0

6.2.4a Public confidence in government

Score: 0

6.2.5a Robust, open, diverse local media and reporting

Score: 0

6.2.6a Gini coefficient

Score: 62.6

6.3.1a Adequacy of road network

Score: 25

6.3.2a Adequacy of airports

Score: 25

6.3.3a Adequacy of power network

Score: 0

6.4.1a Urban population (% of total population)

Score: 87.48

6.4.2a Change in forest area (percentage points)

Score: 65.23

6.4.3a Natural disaster risk

Score: 0

6.5.1a Total life expectancy (years)

Score: 2.75

6.5.1b NCD mortality rate

Score: 66.31

6.5.1c Population aged 65+

Score: 98.67

6.5.1d Tobacco use (% of adults)

Score: 72.6

6.5.1e Level of adult obesity (%)

Score: 96.96

6.5.1f Age-standardised prevalence of mental health disorders (per 100 000 people)

Score: 76.23

6.5.2a Access to potable water

Score: 51.93

6.5.2b Access to at least basic sanitation facilities

Score: 12.88

6.5.2c Percentage of health-care facilities with no access to any electricity supply

Score: 25

6.5.3a Domestic general government health expenditure per capita (PPP)

Score: 1.56

6.5.4a Trust medical and health advice from the government

Score: 0

6.5.4b Trust medical and health advice from medical workers

Score: 0