Molecular TB diagnostic technologies have transformed the global fight against TB by enabling rapid, accurate detection of Mycobacterium tuberculosis and drug resistance. Unlike conventional smear microscopy, molecular platforms significantly reduce diagnostic delay, improve bacteriological confirmation rates, and support early treatment initiation ultimately lowering transmission and mortality. Ensuring the availability of reliable molecular diagnostic tests is therefore a critical pillar for strengthening national TB programs and achieving End TB targets.
REACH Ethiopia has been a pioneer in introducing innovative molecular TB diagnostic technologies in the country. The organization played a key role in piloting and operationalizing both the GeneXpert and Truenat platforms in Ethiopia. Through structured pilot implementation, technical support, capacity building, and operational learning, REACH Ethiopia contributed to generating local evidence that informed national-level scale-up decisions. These efforts strengthened bacteriological confirmation rates, improved drug-resistant TB detection, and supported the expansion of decentralized molecular testing services.
Building on this experience, REACH Ethiopia is currently piloting a third molecular diagnostic option—the TB LAMP technology. TB LAMP has been widely piloted and adopted in several African countries and is used alongside other molecular platforms. Drawing on lessons from previous implementations, REACH Ethiopia identified TB LAMP as a strategic complementary technology, particularly for pastoralist and remote settings where power interruptions and infrastructure limitations affect other platforms. Given the relatively low burden of drug-resistant TB in such areas, TB LAMP offers an appropriate, scalable solution for rapid TB detection.
With support from the Expertise France project, REACH Ethiopia procured and distributed four TB LAMP machines to Zone 3 of the Afar Region. Three machines were installed in selected health facilities, while one was retained at the REACH Ethiopia office to facilitate outreach and mobile screening services across the zone. Comprehensive staff capacity building was conducted, including theoretical and practical training, and all required supplies, consumables, and supportive materials were provided. Additional backup power solutions were also installed to ensure uninterrupted service delivery.
The technology has been effectively utilized during campaign-based screening activities, demonstrating operational feasibility and increased testing throughput. REACH Ethiopia has generated preliminary evidence comparing TB LAMP performance with pooled GeneXpert testing and presented findings to the scientific community at the Union Conference. Data collection is ongoing to further strengthen the evidence base on the effectiveness, feasibility, and programmatic value of TB LAMP within the Ethiopian context.
Ensuring the availability of molecular TB diagnostic tests is a critical requirement for improving diagnostic accuracy and enabling early treatment initiation. Moreover, maintaining more than one molecular diagnostic option within the national program is essential to guarantee service continuity, enhance resilience against supply or power disruptions, and promote cost-effective and context-appropriate solutions for diverse populations across Ethiopia.