Clinical Report: India’s TB Labs Face a Capacity Gap

Overview

India's tuberculosis (TB) diagnostic infrastructure is significantly under-resourced, with a 62% shortfall in culture and drug susceptibility testing laboratories.

Background

Tuberculosis remains a critical public health issue globally, with India contributing to a substantial portion of the incidence. The country's goal of TB elimination by 2025 is hindered by inadequate laboratory capacity and access to essential diagnostic tests.

Data Highlights

India has 97 culture and drug susceptibility testing laboratories, requiring an estimated 283, resulting in a 62% shortfall. There are 6,308 TB treatment units, compared to the recommended 7,084. Only 5% of primary health centers offer the complete set of TB tests recommended for their level of care.

Key Findings

• India has a total of 97 CDST laboratories, while 283 are needed to meet WHO recommendations.
• Only 10% to 67% of surveyed facilities provided all recommended TB tests for their care level.
• Acid-fast bacilli smear microscopy was available in 78% of facilities where it was recommended.
• Cartridge-based nucleic acid amplification testing was available in 51% of community health centers and district hospitals.
• Access to complete blood count testing was available at approximately half of primary health centers.

Clinical Implications

Strengthening diagnostic access at peripheral health facilities is essential for achieving the National TB Elimination Program's goals. Expanding CDST capacity will enhance the identification of drug-resistant TB and improve treatment outcomes.

Conclusion

The significant shortfall in TB diagnostic laboratories in India presents a critical barrier to effective TB management.

Related Resources & Content

1. Foundation for Advancement of Essential Diagnostics, Microbiology Spectrum, 2026 -- India’s TB Labs Face a Capacity Gap
2. the pathologist — Adapting Pathology Practice for Low-Resource Settings
3. the pathologist — TB Triage
4. Open Forum Infectious Diseases — Evaluation of the Practicality of “TB Concentration & Transport” and “TB DNA Extraction” Kits for Safe Ambient Temperature Transport of Dried Sputum and Direct Drug Resistance Detection via Line Probe Assay: A Field Investigation in India
5. WHO consolidated guidelines on tuberculosis: module 3: diagnosis: rapid diagnostics for tuberculosis detection, 3rd ed
6. PMDT structure and roles | Knowledge Base
7. Targeted next-generation sequencing to diagnose drug-resistant tuberculosis: systematic review and test accuracy meta-analysis - PMC