SWITZERLAND — On World Tuberculosis (TB) Day, the SMART4TB Initiative announced a major boost to progress in TB testing, as it joined forces with DriveDx4TB, FEND-TB, and the R2D2 TB Network to create the largest collaboration for TB diagnostics in history.

Launched in 2022, SMART4TB is a 5-year initiative led by Johns Hopkins University and supported by the United States Agency for International Development (USAID).

The initiative aims to transform TB prevention and care by taking a holistic view of improving TB detection, treatments, containment and control strategies, and prevention.

Led by Johns Hopkins University, SMART4TB has brought together an international consortium of research partners and civil society organizations to strengthen research efforts in countries with high TB burdens.

The initiative also seeks to strengthen the transfer of knowledge and capacity to local, regional, and national governments, health institutions, and support organizations.

The partnership will coordinate technology scouting activities and in-country clinical trials, leveraging a global clinical trial network spanning 10 low- and middle-income countries where the TB burden is highest.

To achieve this goal, the initiative has established a Joint Steering Committee with representatives from each project to coordinate technology scouting activities and refer products with potential to the appropriate project, depending on their needs and development stage.

According to Morten Ruhwald, Director of TB at FIND, diagnostic testing is a critical element to stop transmission and save lives, and the collaboration is a significant step towards ending the TB epidemic.

With TB remaining the deadliest infectious disease in the world, killing 1.6 million people in 2021 alone, the collaboration between SMART4TB, DriveDx4TB, FEND-TB, and the R2D2 TB Network creates a critical moment for TB elimination efforts.

This collaboration puts the initiative in a better position than ever before to transform the way TB is diagnosed and managed, ultimately saving millions of lives.

This year marks a critical moment for TB elimination efforts, with a second High-Level Meeting on TB planned for September, building on the UN Resolution on TB signed in 2018.

The SMART4TB initiative’s efforts, coupled with the September meeting, present an opportunity to advance TB elimination efforts and ultimately save millions of lives.

The primary strategy to combat TB for the past four decades has been to provide diagnosis and treatment to individuals who seek care at health facilities.

However, the slow decline in incidence (only 1.5 percent per year) in many countries is concerning. The Directly observed treatment, short-course (DOTS) strategy has been promoted globally, which has been cost-effective and effective in TB control.

Significant progress has been made in TB control, with a decline in mortality rates and lives saved.

However, major gaps remain, including undiagnosed and untreated cases, low case detection and treatment success rates, and the rising incidence of MDR and XDR TB.

Co-infection with HIV/AIDS has also made TB control more challenging in some areas.

Effective case detection, rapid treatment commencement, and adherence to treatment are necessary to interrupt transmission.

New strategies and interventions are required, including new point-of-care diagnostics, more effective drug regimens, and vaccines to reach 2030 targets.

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