Portable molecular tests that work inside a village clinic are reaching 13 countries. A new $10 million commitment pays for the part that usually fails, which is getting health systems to switch.
The Global Fund said on 18 September that the Institute of Philanthropy will put up to US$5 million into near point-of-care tuberculosis testing. The Gates Foundation is matching it, so the total reaches US$10 million. None of that money buys tests. It pays for the technical help countries need before they can use them.
The tests themselves are already on their way. In June the Global Fund said nearly 3 million would reach 13 countries by the end of 2026, among them Bangladesh, Ethiopia, Kenya, Nigeria, South Africa and Viet Nam.
For most of a century, a reliable TB diagnosis has needed a laboratory. These devices move it to the clinic where patients actually turn up, and that’s the shift worth following.
Why has TB diagnosis stayed in the laboratory?
Tuberculosis is still the world’s deadliest infectious disease. WHO’s Global Tuberculosis Report 2025 estimates that 10.7 million people fell ill with TB in 2024, and that it killed 1.23 million of them, including 150,000 people with HIV.
Only 8.3 million of those cases were diagnosed and reported to national authorities. So roughly 2.4 million people were missed, close to a fifth of everyone who fell ill.
Much of that gap is architectural. Accurate molecular testing has needed mains power, a laboratory and trained technicians. Most people with a cough first walk into a small clinic that has none of those things, where sputum smear microscopy, a technique from the 1880s, remains the available option. It misses a large share of cases.
Patients then get referred onward. Plenty never make the second journey, and those who do can wait weeks for an answer.
What do the new tests do differently?
On 9 March, WHO recommended near point-of-care molecular tests for TB for the first time. These are nucleic acid amplification tests built to run at peripheral health facilities, and WHO says they cost less than the molecular tests that came before.
WHO recommended two other changes alongside them. Tongue swabs can now serve as specimens, which helps patients who can’t produce sputum. Sputum pooling lets a laboratory run several samples together to hold costs down.
The devices are small and run on batteries, so a clinic without dependable electricity can still use them. The Global Fund says results come back in under an hour. That means a patient can be tested and started on treatment during one visit.
Why is the price the thing to watch?
A tool reaches people once a health ministry can afford it in bulk. The Stop TB Partnership added Pluslife’s MTB Nucleic Acid Test Card to its Global Drug Facility catalogue in January at US$3.60 a test. The reader costs about US$155 and the sample pretreatment unit US$180.
Caixin Global reported that the Global Fund’s order is worth roughly US$13 million for nearly 3 million tests, supplied by Guangzhou Pluslife Biotech. The reagents keep at temperatures up to 40C, so the cold chain that limits so much diagnostic kit doesn’t apply here.
At that price a district office can put a device in dozens of clinics instead of one hospital. Cheap enough changes the geography of who gets tested.
What usually stops a recommendation reaching a patient?
A WHO recommendation and a purchase order still aren’t adoption. Health ministries have to retrain staff, rewrite national testing algorithms, redirect sample referral systems and connect new devices to reporting databases. Almost no TB budget funds that work, which is what the US$10 million is for.
“Transformative health innovations only deliver their full potential when countries can access them and have the support they need to put them into practice,” said Peter Sands, Executive Director of the Global Fund.
How will we know whether it worked?
The 2.4 million missing cases are the measure. Global Fund-supported programmes treated 7.4 million people for TB in 2025, among them 115,000 with drug-resistant TB.
If moving the test to the clinic does what it should, case notifications in these 13 countries will rise before incidence falls, because those patients were always there. A rising number is the good news. WHO’s next global report is where it will show.
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