The World Health Organization (WHO) has just released a Framework of indicators and targets for laboratory strengthening under the End TB Strategy. The End TB Strategy calls for the early diagnosis of TB including universal drug-susceptibility testing (DST), and a prerequisite for any national TB programme to reach this goal is a quality-assured laboratory network equipped with rapid diagnostics. This Framework, developed in collaboration with a team from the Global Laboratory Initiative core group, serves as a guide for all countries developing plans for laboratory strengthening during 2016–2025.
The 12 core indicators under the Framework measure programmes’ capacity to detect TB accurately and rapidly using new diagnostics, provide universal DST, and ensure the quality of testing. These indicators will be monitored globally by WHO as countries progress towards reaching the targets, and they complement the broader top 10 indicators for monitoring the End TB Strategy as described in the WHO Implementing the end TB strategy: the essentials. The Framework also provides methods for calculating country-specific targets for the numbers of tests and facilities needed for each of the main diagnostic technologies. Given advancements in diagnostic technologies and the need for country-specific targets that consider epidemiology and issues of patient access, the previous global targets that were based on numbers of facilities relative to the general population (1 microscopy center per 100,000 population, 1 culture facility per 5 million population, etc.) are no longer recommended.
“We’re in an era of significant advancements in TB diagnostics, and their adoption and effective use can play a pivotal role under the End TB Strategy”, said Dr Karin Weyer, Coordinator of the Laboratories, Diagnostics and Drug Resistance Unit in the WHO Global TB Programme. “Increasing patient access to high-quality rapid testing and DST must become a priority for all countries, and the indicators and ambitious targets set under this Framework should be a guide for all countries that are serious about ending TB by 2030.”
Questions about the document may be relayed to Wayne van Gemert, Technical Officer: vangemertw@who.int