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A High-throughput Compatible Assay to Evaluate Drug Efficacy against Macrophage Passaged Mycobacterium tuberculosis

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New tuberculosis technologies: challenges for retooling and scale-up.

M Pai¹, K M Palamountain

¹Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada. madhukar.pai@mcgill.ca

The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease

|October 31, 2012

Summary

New tuberculosis diagnostics face adoption challenges in high-burden countries. Overcoming barriers like cost, political will, and user needs is crucial for public health impact.

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Area of Science:

Public Health
Health Technology Assessment
Infectious Disease Control

Background:

New diagnostic tools for tuberculosis (TB) are available but face challenges in adoption and scale-up.
National Tuberculosis Programs (NTPs) in high-burden countries often show reluctance to implement new technologies, despite evidence and policy support.

Purpose of the Study:

To identify and analyze common barriers hindering the effective national adoption and scale-up of new TB diagnostic technologies.
To explore strategies for overcoming these barriers and facilitating the public health impact of innovative TB tools.

Main Methods:

Qualitative analysis of factors influencing technology adoption in national TB programs.
Review of global policy recommendations and country-level implementation experiences.
Identification of common barriers including policy, political, economic, and logistical factors.

Main Results:

Key barriers include insufficient scale-up guidance in global policies, complex decision-making, weak political commitment, and limited support for NTP managers.
High tool costs, poor user fit, unregulated markets, inadequate business models, and insufficient capacity for lab strengthening and implementation research also impede adoption.
Lack of advocacy and donor support further limits the scale-up of new TB diagnostics.

Conclusions:

Overcoming barriers to new TB diagnostic adoption requires enhanced country-level advocacy, resource allocation, technical assistance, and political commitment.
Early adopters, such as some BRICS countries, offer potential for assessing the public health impact of new TB control technologies.