Pooled testing for TB: revisiting a cost-saving innovation

Despite recent advances in screening and diagnosis, tuberculosis remains the deadliest infectious disease. An estimated 10·8 million people developed tuberculosis and 1·25 million died from it in 2023.¹Lagging investment in tuberculosis services and research is a major barrier to elimination. In 2023, of the US$22 billion annual funding target for tuberculosis care, only 26% of funding was available.¹ Chronic underinvestment has led to limited and inequitable access to molecular WHO-recommended rapid diagnostics (mWRDs). In 2023, mWRDs were the initial diagnostic test for 48% of people diagnosed with tuberculosis, and only 35% of tuberculosis diagnostic sites had access to mWRDs globally.¹ The recent abrupt withdrawal of US Government support to the global tuberculosis response will only exacerbate this lack of access to mWRDs.²