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Ahead of World TB Day, Unitaid and FIND welcome WHO resources to accelerate access to faster, more accurate tests for drug-resistant tuberculosis

  • A novel class of diagnostic technology could help hundreds of thousands of people affected with forms of TB that do not respond to first-line drugs quickly access appropriate treatment, if adequately scaled up
  • Targeted next-generation sequencing (tNGS) is a World Health Organization (WHO)-recommended diagnostic technology that can identify resistance to multiple TB drugs in a matter of days, compared with eight weeks required with conventional culture methods
  • The availability of NGS technologies, which can be used for many applications including monitoring and detection of several diseases, rapidly expanded during the COVID-19 pandemic – infrastructure that TB programs can now build on to improve care and reduce the spread of drug-resistant TB
  • Two WHO resources launched this week – new recommendations and a TB sequencing portal – will help drive implementation of tNGS for TB in low- and middle-income countries. The resources were developed based on evidence generated through the Unitaid-funded FIND-led Seq&Treat project
WHO consolidated guidelines on tuberculosis.

Launched in advance of World Tuberculosis (TB) Day, 24 March, new World Health Organization (WHO) resources, underpinned by evidence generated through a Unitaid-FIND project, will help countries implement new technologies that can quickly identify resistance to a range of TB drugs and ensure that patients get the correct treatment with minimum delay.

Drug-resistance is a growing threat to TB care. Each year, close to half a million people become newly infected with strains of TB that are resistant to one or more of the drugs used to treat it. Only about 2 in 5 people access treatment, allowing drug-resistant TB (DR-TB) to spread. Of those who do reach care, a lack of insight into drug-resistance can impede their access to appropriate treatment.

A novel class of diagnostic technologies called targeted next generation sequencing (tNGS) can analyze the genes of the TB bacteria infecting a person and determine, in just a few days, which drugs are likely to work best. Compared with conventional culture-based tests that require up to eight weeks to identify resistance, these tools could significantly improve diagnosis and treatment success if implemented widely.

Targeted NGS is essential to supporting the rollout of new, shorter DR-TB regimens containing the drug bedaquiline, which alternative rapid diagnostic platforms do not have the capacity to identify. Moreover, tNGS can detect resistance to multiple drugs simultaneously and has the potential to integrate new resistance profiles as they become known – critical to staying ahead of TB mutations.

“The COVID-19 pandemic triggered rapid uptake of sequencing technology around the world, including in most, if not all, low- and middle-income countries,” said Dr Philippe Duneton, Executive Director of Unitaid. “When Unitaid first invested in this technology we never expected capacity to take off so quickly – if we act now, we can piggyback off these improvements in infrastructure to help countless people with drug-resistant tuberculosis get connected with the right treatment without delay.”

The new WHO tools provide critical guidance so countries can make use of sequencing capacity for TB diagnosis. WHO guidelines and the accompanying operational handbook will help operationalize the July 2023 recommendation, supported by the new TB sequencing portal, which serves as the knowledgebase to understand the association between mutations in the genes and resistance to TB medicines. The portal, developed in partnership with Unitaid and FIND, will help ensure that countries have the latest data on TB drug-resistance and that emerging resistance profiles can be quickly added to tNGS platforms.

“The endorsement by WHO of next-generation sequencing marks a pivotal moment, with the potential to significantly advance progress toward achieving the 2030 end TB goals,” said Dr Sergio Carmona, acting CEO and Chief Medical Officer at FIND. “Collaborating with Unitaid and partners to validate this technology has revealed its transformative power, enabling precise and rapid identification of optimal TB treatments, thereby potentially saving countless lives”

Countries and researchers are encouraged to contribute their DR-TB datasets to the sequencing portal to continue to strengthen the associations of TB mutations with drug-resistance.

The Unitaid-funded Seq&Treat project, led by FIND, has piloted sequencing technology for DR-TB diagnosis, informing the WHO’s recommendation for its use and laying the groundwork for scale-up in support of endTB targets.

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About FIND

FIND accelerates equitable access to reliable diagnosis around the world. We are working to close critical testing gaps that leave people at risk from preventable and treatable illnesses, enable effective disease surveillance, and build sustainable, resilient health systems. In partnership with countries, WHO and other global health agencies, we are driving progress towards global health security and universal health coverage. We are a WHO Collaborating Centre for Laboratory Strengthening and Diagnostic Technology Evaluation. For more information, please visit

About Unitaid

We save lives by making critical health products available and affordable for people in low- and middle-income countries. We work with partners to identify innovative treatments, tests and tools, help tackle the market barriers that are holding them back, and get them to the people who need them most – fast. Since we were created in 2006, we have unlocked access to more than 100 groundbreaking health products to help address the world’s biggest health challenges, including HIV, TB, and malaria; women’s and children’s health; and pandemic prevention, preparedness and response. Every year, more than 170 million people benefit from the products we’ve helped roll out.