Civil society published the below call to action during a Global Fund-hosted meeting with National TB Programs, lab managers, and other stakeholders from the South-East Asia and Western-Pacific regions to plan early for the introduction of new near point of care sample types and tests for TB. The call to action, which was endorsed by TAG urges governments and donors to address critical gaps in TB testing and care by increasing domestic funding, decentralizing and expanding access to rapid molecular diagnostics — especially in underserved communities — and adopting innovative, point-of-care technologies. It emphasizes the need for ambitious, measurable implementation plans, stronger community engagement, and coordinated efforts to make life-saving TB diagnostics affordable and universally accessible, particularly in the face of reduced international funding and persistent barriers for vulnerable populations.

The call to action was modeled after another that was published by civil society representatives from the African region in November during the African Society for Laboratory Medicine (ASLM) Special Convention on Diagnostics — read it here.

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Civil Society Call to action: At the Joint SEAR-WPR workshop to plan the accelerated implementation of new WHO TB policies 1-4 April 2025, Hanoi, Vietnam

April 4, 2025 – On behalf of the civil society and communities advocating for scaling up access to diagnostics to address the deadly gaps in TB testing, we would like to issue the following call to action.

Our call is against the backdrop of draconian cuts to and profound uncertainties about future support for the global TB response. The funding freezes on US external aid, the ODA cuts in the UK, and further reductions in France and among other donors risk squandering scientific progress that has resulted in better prevention, therapeutic, and diagnostic tools and operational lessons in supporting people with TB and its drug-resistant forms.

1. 1. The urgency to reduce donor dependency and increase domestic TB financing has never been greater. Governments must take leadership and develop innovative financing solutions to end TB in the region. Local governments need increased funding to implement effective TB programs. TB plans must be needs-based and fully funded for proper execution. Though the transition to domestic financing was abrupt, the region must collectively build sustainable leadership and secure long-term funding to end TB.
   2. We need to improve TB testing, the critical gateway to care, and increase those diagnosed with WHO recommended rapid molecular tests. The Southeast Asia and Western Pacific regions represent 45% of the current global TB testing Only 39% and 60% of people were diagnosed using recommended rapid molecular testing in SEARO and WPRO regions, respectively.
   3. We need to help those who are being left behind: those seeking care in the private sector who are referred late for confirmatory tests; children who don’t have access to gastric aspiration; those expected to pay the costs of additional TB tests (e.g. extra pulmonary TB and DST); migrants, refugees, IDPs and other key and vulnerable populations; and, everyone affected by stockouts, from sputum collection cups to GeneXpert supplies. National efforts against TB can’t expect to succeed if we don’t address these problems.
   4. Geographic barriers significantly hinder TB diagnosis, forcing many to make lengthy, costly trips to provincial centers for molecular testing. This centralized model delays diagnosis and disproportionately affects rural and remote populations. We must urgently decentralize specimen collection and TB testing, bringing services closer to communities.
   5. Innovative approaches like oral swab sampling and near point-of-care testing can reduce travel, accelerate diagnosis, and ensure equitable access to life-saving TB detection and treatment. We want to see near point of care testing in every primary health care facility. Placement must prioritize proximity—to bring testing to underserved communities; urgency—to address preventable deaths.
   6. We call for ambitious measurable implementation roadmaps and strategic plans, with a vision of extending point-of-care and near-point-of-care testing to every primary healthcare center. This will ensure early and accurate TB diagnosis for all, regardless of location.
   7. Investing in community engagement alongside the scale-up of new and existing TB diagnostics is essential to ending TB. An informed and empowered community can demand services, combat stigma, protect rights, and ensure equitable access to TB care. Governments and donors must sustain investments in community-led responses, as doing so is both the right and the smart
   8. Governments, global health actors, and donors must coordinate ambitious plans and strategies for new TB tests driven by high ambition to secure the most affordable prices possible. High ambition and high volumes lead to lower costs, bringing future affordability into the This is an economic and moral imperative to make these life-saving diagnostics universally accessible.

Civil society remains committed to collaborating with you to strengthen efforts to scale up TB testing and plan for the inclusion of future diagnostics, while raising literacy within our communities.

We stand as your allies, committed to working alongside you and holding all partners accountable to ensure that communities have sustainable access to quality, affordable, suitable, and effective diagnostics.

ENDORSED BY: