Where We Work


Fighting Disease

Chad has waged a seesaw battle with Guinea worm disease since the 1990s. Transmission of the ancient disease was believed to have been stopped in 1999, but new cases were discovered and the country was reclassified as endemic in 2012. The Carter Center continues to work with village volunteers and Ministry of Health officials to eliminate the disease.

Eliminating Guinea Worm Disease

Current status: Endemic
Indigenous cases reported in 2021: 8*

Previous status: Transmission stopped, 1999. Prior to 2012, Chad was in precertification status. Reclassified as endemic in 2012.

View current case totals >


During 2021, just eight* human cases of the disease were reported in Chad, down from 12 reported in 2020. There were 855 animal infections (790 domestic dogs, 65 domestic cats) in 2021, down sharply from 1,570 (1,507 domestic dogs, 61 domestic cats, and two wild cats) in 2020.

In recent years, Chad has had the most human cases and animal infections of any country. The main endemic area is spread over 400 miles along the Chari River. Most animal infections apparently are transmitted by eating raw or poorly cooked fish; people are encouraged now to bury or burn fish entrails rather than feeding them to dogs. Ten dog infections reported across the river in Cameroon in 2021 may have been incurred in Chad, as families in that area frequently cross the border. Significantly, there were seven months in 2021 with no human cases.

Chad improved containment rates and coverage with the larvicide Abate® (donated by BASF) in 2019-2020 and reduced animal infections by 22% and human cases by 75% in 2020 compared to 2019.

Elimination Activities, 1993-2000

When its Guinea worm elimination efforts began in 1993, Chad had 1,231 cases in 106 villages in six of the nine national provinces. The strategy for interrupting transmission focused primarily on educating residents about the origin of the disease and how to prevent it. The Carter Center provided technical and financial assistance.

Through these efforts, in 1999 the country had its last indigenous case and met the criteria for breaking transmission of Guinea worm disease (having reported no indigenous cases for 12 consecutive months). Chad was honored at a special ceremony at The Carter Center in Atlanta in 2000 for having stopped Guinea worm disease transmission.


After more than a decade with no indigenous cases reported, 10 cases of Guinea worm disease were found in eight villages during a World Health Organization precertification mission to Chad in July 2010. In 2011, when 10 additional cases were reported from nine different villages, Chad's Ministry of Public Health formally asked The Carter Center to assist with a revived Guinea Worm Eradication Program.

Having reported indigenous cases for the third consecutive year in 2012, Chad officially returned to endemic status.

Around the same time, Guinea worm infections in animals (mainly domestic dogs) started being detected in increasing numbers. The worm’s life cycle in animals is not yet well understood, but intensive research continues. Cash rewards are being paid for reporting infected dogs and for keeping them away from water sources where the worms could reproduce.

Since 2011, program staff members have enhanced surveillance by training more than 2,500 village volunteers in more than 880 villages.

The village volunteers teach techniques to prevent contamination of drinking water, provide free first aid, and immediately report cases to public health authorities. Monetary rewards for information leading to confirmation of Guinea worm cases are publicized through local radio stations, posters, and person-to-person networks.

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