# Strengthening TB laboratory systems: addressing diagnostic and systemic barriers in drug-resistant TB

## TL;DR

This paper discusses challenges in diagnosing drug-resistant TB and emphasizes the need for improved lab systems and international collaboration.

## Contribution

The paper introduces a system-level approach to strengthen TB diagnostic systems through national leadership and international coordination.

## Key findings

- TB diagnostic labs face issues like contamination, workload, and unreliable results.
- Systemic issues include infrastructure and paper-based reporting.
- International coordination is needed for quality assurance and new diagnostic technologies.

## Abstract

As part of the LIFT-TB project, we investigated the efficacy and safety of the BPaL regimen, while enhancing laboratory diagnostic capacity for drug-resistant-TB. Challenges include sample contamination, excessive workload, test kit shortages, unreliable results and systemic issues such as infrastructure, delayed procurement, workforce constraints and reliance on paper-based data reporting. Our study highlights the need for a system-level approach backed by strong national leadership to strengthen TB diagnostic capacity. Although countries must take ownership of laboratory system improvements, a harmonized and coordinated approach among international stakeholders is essential in specialized areas, such as external quality assurance, capacity building, and introducing innovative diagnostic technologies.