Key bottlenecks in M/XDR-TB control and patient care
Responding to the laboratory bottleneck
Until WHO’s Stop TB Strategy was launched in 2006, global TB control efforts underplayed the need for laboratories. This paper addresses the gap which has built up and calls for TB laboratory needs to be addressed in strategic plans for the national health laboratory system as a whole. Meeting this gap will require an additional 2000 new or revitalized laboratories capable of culture and drug sensitivity testing to be established and more than 20,000 new laboratory technicians to be trained and deployed. A systematic approach at country level to planning of laboratory costs is essential, starting with clear policies for screening of patients at risk of MDR-TB and applying appropriate diagnostic algorithms using the different modalities available.