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

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.