Viewpoint TB diagnostics: what does the world really need?

Stagnant tuberculosis (TB) case detection and rising TB drug resistance are in part the result of historically neglected laboratory services, slow technology transfer, and a lack of new TB diagnostic tools. The last decade has, however, seen the diagnostic pipeline grow rapidly, with research and investment prompted by concerns about the global spread of drug resistance and transmission in human immunodeficiency virus (HIV) settings. The drawbacks of conventional microbiological methods for TB diagnosis and resistance detection have largely been overcome by modern molecular technologies; however, the much needed point-of-care TB test will remain elusive if expectations stay unrealistic and research and funding strategies are not changed. Development of new technologies, better use of existing tools, and adequate treatment capacity to care for the increasing numbers of cases that will be diagnosed with scale-up of TB diagnostics all need to be addressed simultaneously.