Context

• The history of tuberculosis (TB) control has been shaped by periodic scientific breakthroughs, but few have been as transformative as the advent of point-of-care molecular diagnostics.
• For decades, TB detection depended on insensitive sputum smear microscopy or prolonged culture processes conducted in centralised laboratories.
• These methods not only delayed diagnosis and treatment but also disproportionately affected populations living in remote or resource-limited settings.
• The introduction of portable, battery-operated polymerase chain reaction (PCR) platforms has radically altered this landscape, making timely and accurate diagnosis accessible to those who need it most.

A Diagnostic Game Changer

• Rapid molecular diagnostic systems such as Truenat, endorsed by the World Health Organization (WHO), have emerged as vital tools in global TB control.
• Their capacity to detect tuberculosis and drug resistance in under an hour has fundamentally reshaped screening and treatment pathways.
• Evidence from Nigeria illustrates this impact: after integrating Truenat into its national TB program, the country nearly doubled its detection of rifampicin-resistant cases.
• Equally significant is Nigeria’s innovative adoption of stool-based testing for children, a solution that bypasses the difficulty of obtaining sputum samples and enhances diagnostic accuracy in paediatric TB, historically an under-diagnosed segment of the disease burden.
• Further validation comes from a multi-country study published in The Lancet, evaluating the use of on-site molecular diagnostics in primary healthcare settings in Mozambique and Tanzania.
• The results were striking: rapid testing coupled with swift result dissemination substantially increased the proportion of patients who began treatment within seven days of their first visit.

Global Recognition of Indian Innovation

• The transformative potential of point-of-care diagnostics gained worldwide recognition when Goa-based Molbio Diagnostics received the prestigious Kochon Prize.
• Awarded by the Kochon Foundation in partnership with the Stop TB Partnership, this prize honours pioneering contributions to TB control.
• Molbio’s recognition signifies more than the success of a single organisation; it represents a milestone for India’s scientific and technological ecosystem.
• Indian innovations are now influencing TB eradication efforts globally, proving that affordable, scalable solutions developed in India can reshape health outcomes far beyond its borders.
• In 2020, the WHO endorsed India’s portable molecular diagnostic platform after evidence from diverse studies across Asia and Africa demonstrated performance comparable to central laboratory systems, with the added advantage of deployability in remote settings.
• This was a defining moment when innovation aligned with accessibility. Since then, a growing number of Indian enterprises have entered the TB diagnostics space, enriching the range of point-of-care tools available worldwide.

India’s Role in Decentralised TB Control

• India's National TB Elimination Programme (NTEP) has been pivotal in scaling these innovations domestically.
• By installing thousands of molecular testing units across the country, the programme has significantly reduced the time from suspicion of TB to treatment initiation, strengthening the overall TB management framework.
• The success of these efforts reflects India’s broader collaborative model: a synergy between government systems, private innovators, academia, and community health workers.
• In a nation that accounts for nearly a quarter of the global TB burden, such cross-sector cooperation is more than beneficial, it is essential.
• The repeated recognition of Indian contributions with the Kochon Prize, in 2006, 2017, and again today, underscores India’s growing leadership in global TB control.
• The widespread deployment of India-made diagnostic tools, from sub-Saharan Africa’s mobile clinics to Eastern European refugee camps, further exemplifies this leadership.
• These developments affirm that India is not merely participating in global health innovation; it is driving it.

The Way Forward: The Need for Holistic TB Care

• Despite these achievements, the fight against TB is far from over.
• Diagnostic advancements must be matched by equitable access to treatment, social support, nutritional interventions, and stigma reduction.
• Research indicates that malnutrition accounts for roughly 40% of TB cases in India, an alarming figure that highlights the deep connection between disease and socio-economic inequity.
• TB is, fundamentally, a disease of disadvantage. Successful elimination, therefore, requires addressing the structural determinants that sustain the epidemic.

Conclusion

• As the world stands at a critical juncture in the battle against TB, it is essential to maintain momentum.
• Continued investment in integrated innovations, combining diagnostics with nutritional support, digital adherence technologies, expanded contact tracing, and vaccine development, is vital.
• Only through this comprehensive approach can global health systems move beyond piecemeal interventions and forge a truly equitable path to TB elimination.