Progress in tuberculosis diagnosis and laboratory services in the Western Pacific Region: a situational analysis of seven high tuberculosis burden countries

BACKGROUND: Timely, accurate tuberculosis (TB) diagnostics and strong laboratory networks are critical for providing high-quality TB care. In the Western Pacific Region, available resources, TB burdens, and access to TB testing vary dramatically between countries. To understand the current regional situation, we described TB diagnostic test availability and laboratory services in seven countries with high TB burdens in the Western Pacific Region: MAIN TEXT: In 2024, World Health Organization's (WHO) Western Pacific Regional Office conducted an assessment of TB diagnostic test availability and laboratory services in seven countries with high TB burdens: Cambodia, China, Lao People's Democratic Republic, Mongolia, Philippines, Papua New Guinea, and Viet Nam. Standardised surveys were sent to members of country national tuberculosis programmes, and follow-up interviews were conducted. An in-person workshop was attended where preliminary findings were presented and updated, if necessary. The exercise revealed a high uptake of WHO-endorsed rapid molecular tests for TB detection, although the use of smear microscopy persists in most countries' remote areas. Regarding drug susceptibility testing, both molecular and phenotypic methods are employed. Testing for first-line TB drug resistance is generally available, but currently, testing capacity for new and re-purposed drugs remains limited. Most countries provide TB testing at district-level facilities in conjunction with well-established specimen transport networks, with laboratories utilising a mix of paper and electronic databases. Comprehensive TB and drug-resistance testing at peripheral settings remains a rarity. CONCLUSIONS: The Western Pacific Region has invested significantly in TB testing and laboratory services. To ensure everyone in the region has access to TB diagnostics, these efforts must be maintained.