Collaboration agreement unveiled between SMART4TB, DriveDx4TB, FEND-TB and the R2D2 TB Network, representing the largest-ever coordinated effort to accelerate TB diagnostic development; memorandum of understanding signed between FIND (https://www.FINDdx.org/) and the Johns Hopkins University, with agreements also in place with the University of California San Francisco (UCSF), Rutgers University and Heidelberg University Hospital; a Joint Steering Committee will oversee a coordinating hub with global expertise for the development of key diagnostic technologies in TB, aligned with the goals set out in the UN Resolution on TB from 2018 that will be reviewed at a second High-Level Meeting in September.

Today, on World TB Day, FIND and partners announced a set of agreements between FIND, Johns Hopkins University, University of California San Francisco (UCSF), Rutgers University and Heidelberg University Hospital that bring together the SMART4TB, DriveDx4TB, FEND-TB and R2D2 TB Network projects to form the largest-ever coordinated effort to accelerate TB diagnostic development.

Supporting, Mobilizing, and Accelerating Research for Tuberculosis Elimination (SMART4TB) (https://apo-opa.info/3JNQXhM) is a 5-year initiative made possible by the generosity of the American people through the United States Agency for International Development to transform TB prevention and care. Launched in 2022, it is led by Johns Hopkins University, convening an international consortium of research partners and civil society organizations, to take a holistic view of improving TB detection, treatments, containment and control strategies, and prevention. Additionally, it aims to strengthen research efforts in countries with high TB burdens and to transfer knowledge and capacity to local, regional and national governments, health institutions and support organizations.

DriveDx4TB (https://apo-opa.info/3Zb3C3N) is a Unitaid-funded project led by FIND that was also set up in 2022, to increase TB testing options and evaluate alternative sampling methods to accurately diagnose more people and connect them to care. Project partners are identifying and evaluating new technologies that have the potential to enable TB testing closer to where people need access to it, such as in primary care clinics and community settings. They are also advancing development of tests that use biological samples other than the traditional sputum, which can be difficult and uncomfortable to obtain for many people.

The Feasibility of Novel Diagnostics for TB in Endemic Countries (FEND-TB) (https://apo-opa.info/3lDgSAx) project is led by Rutgers University, supported by the U.S. National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health (NIH). It supports the evaluation of early-stage TB diagnostics and novel diagnostic strategies in the context of existing clinical algorithms in TB-endemic countries. The project will also perform proof-of-principle studies of novel diagnostics and strategies, and provide feedback to diagnostic developers on the performance of the technologies and their most effective use in endemic settings.

The Rapid Research in Diagnostics Development for TB Network (R2D2 TB Network) (https://apo-opa.info/3lGYoPB), led by the UCSF Center for TB and also supported by the U.S. NIAID/NIH, brings together experts in TB care, technology assessment, diagnostics development, laboratory medicine, epidemiology, health economics and mathematical modelling, providing a transparent and partner-engaged process for the identification, evaluation and advancement of the most promising TB diagnostics.

A Joint Steering Committee with representatives from each project has been established, to coordinate technology scouting activities, and refer products with potential to the appropriate project, depending on their needs and development stage. In-country clinical trials of different technologies will also be coordinated, leveraging a global clinical trial network spanning 10 low- and middle-income countries where the TB burden is highest.

Morten Ruhwald, Director of TB at FIND, said: “The 2030 goal of ending the TB epidemic remains ambitious, but the roadmap to get there is clear and diagnostic testing is a critical element to stop transmission and save lives. DriveDx4TB joining forces with SMART4TB, FEND-TB and the R2D2 TB Network creates the biggest collaboration for TB diagnostics in history, putting us in a better position than we have ever been to transform the way this deadly disease is diagnosed and managed.”

TB is the deadliest infectious disease in the world, killing 1.6 million people (https://apo-opa.info/3K46qeH) in 2021 alone. Estimates indicated that more than 3 million infections (https://apo-opa.info/40a1B9x) were never notified to national health systems that year. Low- and middle-income countries bear the greatest burden of the disease.

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