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Lessons from Ukraine: Bringing Next-Generation Molecular TB Diagnostics to the Frontlines
How a health system under wartime pressure kept tuberculosis diagnosis and treatment running and what it means for the future of decentralized, molecular TB testing.
Lessons from a Resilient System
Ukraine’s health system has demonstrated remarkable resilience in maintaining essential TB diagnostic and treatment services despite the immense challenges of war. This experience offers a blueprint for global TB control, proving that even in high-stress, conflict-affected environments, containment is possible through a robust, multifaceted approach.
Ukraine’s success was not the result of a single technology, but rather a comprehensive system that prioritized patient-centered care. Key pillars of this success included:
- Strong screening programs:the deployment of mobile teams to carry out thousands of field screenings allowed for active case finding in remote and underserved communities.
- Robust laboratory networks:maintaining a nationwide network of over 200 laboratories ensured that diagnostic capacity remained functional despite infrastructure disruptions.
- Rapid molecular diagnostics:by 2025, 96% of newly detected patients were diagnosed using rapid molecular tests, which are crucial for enabling immediate treatment initiation.
- Comprehensive drug resistance testing:testing 90% of confirmed cases for drug resistance allowed clinicians to move quickly to effective, targeted regimens.
An untreated person with active TB can infect up to 15 others in a single year every intervention that accelerates the time from screening to treatment is a vital act of prevention
The Role of Targeted Diagnostics in Patient Care
The global shift toward more precise diagnostics is essential to addressing the threat of multi drug-resistant tuberculosis (MDR-TB). Understanding specific genetic mutations is no longer just a technical exercise; it is a clinical necessity for personalized care.
For example, mutations in the rpoB gene are highly associated with rifampicin resistance, while mutations in inhA and katG are primary drivers of isoniazid resistance. Similarly, mutations in the gyrA gene can indicate resistance to fluoroquinolones.
Identifying these mutations allows clinicians to bypass ineffective drugs and rapidly transition patients to modern, fully oral, and often shorter treatment regimens, such as the four drug BPaLM protocol, which combines bedaquiline, pretomanid, linezolid, and moxifloxacin a combination that has significantly improved outcomes for people with MDR-TB.
Advancing Access to Reliable Diagnostics
At EMPE Diagnostics, we are working to contribute to this global effort by focusing on near Point-of-care (nPOC) diagnostic solutions. Our commitment to developing an affordable tuberculosis diagnostic test directly addresses the exact needs described in this story.
By advancing padlock probe molecular diagnostics and qRCA technology, we aim to provide the tools that allow healthcare workers to rapidly identify pre-XDR TB and MDR TB strains, as well as linezolid and bedaquiline resistance, to support the broader transition toward decentralized, accessible testing.
The goal of these innovations is to ensure that healthcare providers in diverse environments, from stable clinics to the most challenging frontlines, have the diagnostic tools necessary to make informed clinical decisions.
Ultimately, strengthening the global response to TB depends on our collective ability to simplify diagnostic pathways and increase the reach of reliable testing, ensuring that every patient, regardless of their location, can access the rapid, accurate diagnosis required to begin their journey toward recovery.