The World Health Organization (WHO) has unveiled a new set of recommendations aimed at transforming the diagnosis of Tuberculosis (TB), introducing faster, simpler, and more cost-effective testing approaches.
In updated guidance expected to be formally released later this year, WHO highlights three key innovations: near point-of-care molecular tests, the use of tongue swabs as an alternative sample, and sputum pooling strategies. These advancements are designed to improve access to testing, particularly in low-resource and community-level health settings.
Central to the recommendations is a new class of near point-of-care nucleic acid amplification tests (NPOC-NAATs). These tests allow for rapid detection of TB at peripheral health facilities such as primary healthcare centres and community clinics, reducing reliance on centralized laboratories. WHO notes that these tests are not only efficient but also more affordable compared to existing molecular diagnostic tools.
The organization is also endorsing the use of tongue swabs as a practical alternative for patients who are unable to produce sputum samples. This method simplifies specimen collection, especially among children, adolescents, and severely ill patients, while maintaining diagnostic accuracy when used with appropriate testing technologies.
WHO has recommends sputum pooling — a strategy that combines samples from multiple individuals for testing — as a way to cut costs and improve efficiency in high-demand or resource-constrained environments. This approach can accelerate turnaround times and expand testing coverage, including for rifampicin-resistant TB.
According to WHO, these updates are based on emerging evidence since the release of the 2025 consolidated guidelines on TB diagnosis. The forthcoming second edition of the WHO consolidated guidelines on tuberculosis, Module 3: Diagnosis, will provide comprehensive policy direction, supported by evidence reviews conducted under the GRADE framework.
The updated guidance will be accompanied by an operational handbook detailing implementation strategies, diagnostic algorithms, and best practices for integrating new technologies into national health systems. A dedicated toolkit will also support countries in planning, training, and monitoring the rollout of these innovations.
WHO says it will further support implementation through regional webinars and its TB Knowledge Sharing Platform, enabling countries to align national policies, strengthen diagnostic capacity, and improve patient outcomes.
The new recommendations are expected to play a critical role in accelerating global efforts to detect TB earlier, reduce transmission, and address the growing challenge of drug-resistant forms of the disease.
