The introduction of ART presents an enormous opportunity in terms of reducing morbidity and mortality due to AIDS worldwide. Ethiopia has been engaged in the scale up of ART access to its people since 2005. The free ART program was launched in July 2005. Despite the many challenges, ART scale up has recorded the greatest achievement over the last few years. The service has been expanded from only three health facilities in 2005 to 400 in 2008. The number of people ever started on ART has also shown an unprecedented increase during the same period from 900 in 2005 to 180,447 by end of December 2008.