In a major push to strengthen the fight against tuberculosis, the World Health Organization is set to introduce updated diagnostic guidelines featuring new, more accessible testing approaches aimed at improving early detection and identifying drug resistance.

The forthcoming update to WHO’s tuberculosis diagnostic guidelines—expected later this year—marks the first time the global health body has endorsed a new class of near point-of-care molecular tests, alongside innovative sample collection methods such as tongue swabs and cost-saving strategies like sputum pooling.

These changes come as part of WHO’s ongoing effort to help countries detect TB cases more efficiently, particularly in resource-limited settings where access to advanced laboratory infrastructure remains a challenge.

At the heart of the new recommendations are near point-of-care nucleic acid amplification tests (NPOC-NAATs), which allow for faster diagnosis at peripheral health centres and community settings. These tests are not only easier to deploy but are also expected to reduce costs compared to traditional molecular diagnostic tools.

In a notable shift, WHO is also recommending the use of tongue swabs as an alternative to sputum samples. This method is especially beneficial for patients—such as children and some adults—who struggle to produce sputum, making TB testing more inclusive and easier to administer.

Another key strategy highlighted in the updated guidance is sputum pooling, where multiple samples are tested together. This approach can significantly cut costs and improve turnaround times, particularly in settings with limited resources, while still enabling detection of TB and resistance to rifampicin, a key first-line drug.

The updated recommendations build on WHO’s 2025 consolidated guidelines and reflect new evidence on diagnostic tools, sample types, and testing strategies. The full policy update will be published in the second edition of WHO Consolidated Guidelines on Tuberculosis: Module 3 – Diagnosis, accompanied by detailed evidence reviews developed using the GRADE methodology.

To support implementation, WHO will also release an operational handbook and a dedicated toolkit outlining practical steps for adopting these new technologies. These resources will include guidance on planning, training, testing protocols, and monitoring systems to help countries integrate the new approaches into their national TB programmes.

The rollout will be supported by a series of regional webinars and updates on WHO’s TB Knowledge Sharing Platform, ensuring easy access to guidance and best practices.

With tuberculosis still among the world’s deadliest infectious diseases, WHO officials say these innovations could play a crucial role in closing diagnostic gaps and accelerating global efforts to control and eventually eliminate the disease.