WHO Launches New Global Toolkit to Expand Faster, Easier Tuberculosis Testing Closer to Patients

Tuberculosis remains one of the world’s deadliest infectious diseases, with millions of people still missing diagnosis and treatment each year despite being preventable and curable.

The World Health Organization (WHO) and the Stop TB Partnership have launched a major new implementation toolkit aimed at helping countries rapidly expand access to faster, simpler, and more accessible tuberculosis (TB) testing — particularly in primary healthcare and community settings where millions of cases continue to go undiagnosed.

The newly released TB Near Point-of-Care and Swab-Based Testing Toolkit is designed to support countries implementing WHO's latest recommendations on near point-of-care nucleic acid amplification tests (NPOC-NAATs) and tongue swab-based diagnostic methods.

Health experts say the initiative could significantly improve early TB detection, especially among vulnerable populations who struggle to access conventional diagnostic services or cannot produce sputum samples required for standard testing.

New Diagnostic Technologies Aim to Bring TB Testing Closer to Communities

The toolkit supports deployment of a new generation of molecular diagnostic technologies that can be used in:

• Basic laboratories

• Primary healthcare clinics

• Community health settings

• Decentralized testing facilities

WHO says these near point-of-care molecular tests complement existing laboratory-based TB diagnostics by enabling countries to expand accurate testing much closer to where patients first seek care.

Tuberculosis remains one of the world's deadliest infectious diseases, with millions of people still missing diagnosis and treatment each year despite being preventable and curable.

Public health experts warn that delayed diagnosis remains one of the biggest barriers to controlling transmission and reducing TB-related deaths globally.

Tongue Swab Testing Opens New Pathway for Vulnerable Patients

One of the most significant developments highlighted in the toolkit is WHO's new recommendation supporting the use of tongue swabs for TB diagnosis among adults and adolescents who are unable to produce sputum samples.

This is considered a major breakthrough for groups at particularly high risk of TB-related illness and death, including:

• Severely ill patients

• Individuals with advanced HIV

• Elderly patients

• People with difficulty expectorating sputum

• Vulnerable or marginalized populations

Traditionally, TB diagnosis has relied heavily on sputum collection, which can be difficult or impossible for some patients.

The new guidance allows tongue swab specimens to be used with both:

• Near point-of-care nucleic acid amplification tests (NPOC-NAATs)

• Low-complexity automated molecular tests

WHO says this could substantially improve diagnostic access while reducing barriers to timely testing.

Toolkit Designed for Rapid Country-Level Adaptation

The WHO and Stop TB Partnership say the toolkit was specifically designed to be flexible and adaptable for use by national TB programmes in diverse healthcare settings.

The package includes a wide range of practical implementation resources, including:

• Readiness assessment checklists

• Training materials and slides

• Competency assessment tools

• Method verification protocols

• Standard operating procedures (SOPs)

• Job aids for specimen collection and testing

• Site-level capacity calculators

• Automated monitoring and evaluation spreadsheets

Officials say the toolkit is intended to help countries accelerate evidence-based and quality-assured rollout of the new testing approaches while aligning implementation with national guidelines and health priorities.

Expanding Molecular Testing Seen as Critical to Ending TB

WHO has increasingly prioritised molecular testing technologies as part of global efforts to improve TB diagnosis and treatment outcomes.

Nucleic acid amplification tests (NAATs) are capable of rapidly detecting TB bacteria and identifying drug resistance with significantly greater accuracy and speed than older diagnostic methods.

Expanding access to these technologies is considered especially important in low-resource settings where delays in diagnosis often contribute to continued disease transmission and preventable deaths.

By decentralising access to high-quality diagnostics, health agencies hope to close major gaps in TB detection that continue to undermine global eradication efforts.

TB Remains Major Global Health Threat

Tuberculosis continues to pose a major global public health challenge despite decades of international control efforts.

According to WHO:

• TB remains among the leading infectious disease killers worldwide

• Millions of new TB cases occur annually

• Drug-resistant TB remains a growing threat

• Large numbers of cases still go undetected or untreated

The disease disproportionately affects low- and middle-income countries, where healthcare infrastructure limitations, poverty, malnutrition, and HIV co-infection continue to drive transmission.

Global health agencies say improving early diagnosis is one of the most effective ways to reduce transmission, improve survival rates, and prevent drug resistance.

Toolkit Supports WHO End TB Strategy

The NPOC/swab toolkit forms part of broader efforts to achieve WHO's global End TB Strategy targets, which aim to dramatically reduce TB deaths, incidence, and catastrophic economic costs associated with the disease.

WHO says easier and more accessible testing strategies are essential if countries are to meet those goals.

"This NPOC/swab toolkit aims to accelerate evidence-based, quality-assured scale-up of these new TB diagnostic interventions by equipping countries with practical, ready-to-use tools," the organisations said.

Officials believe the combination of rapid molecular diagnostics and simplified specimen collection methods could significantly improve case detection rates, particularly in underserved populations.

Broad International Collaboration Behind Toolkit Development

WHO acknowledged the contributions of numerous technical experts and international organisations involved in developing and reviewing the toolkit.

Key contributors included:

• R2D2 TB Network

• Stop TB Partnership

• Global Laboratory Initiative (GLI) Core Group

• Technical specialists in TB diagnostics and programme implementation

The collaborative effort reflects growing international emphasis on accelerating innovation and implementation in global TB control strategies.

Community-Based Testing Becoming Increasingly Important

Public health specialists say community-based testing approaches are becoming increasingly critical as countries seek to identify TB cases earlier and reduce diagnostic delays.

Decentralized testing models can help:

• Reach underserved populations

• Reduce patient travel burdens

• Improve treatment initiation speed

• Lower healthcare system bottlenecks

• Strengthen disease surveillance

Experts believe the new toolkit could play an important role in helping countries operationalise these approaches more quickly and consistently.

As countries continue modernising TB programmes, WHO says expanding accessible molecular diagnostics closer to communities will be essential to reducing the global burden of tuberculosis and moving closer toward eventual elimination targets.