The TB Paradigm Shift: How Active Screening and Precision Diagnostics Are Rewriting China's End‑TB Playbook

Tuberculosis (TB) remains the world's deadliest single infectious disease. Despite being preventable and curable, global progress to eliminate it remains slow a decade after the WHO launched its End TB Strategy.

Its impact is devastating:

• Health & Life: In 2024 alone, TB caused 10.7 million new cases and 1.23 million deaths, severely weakening patients physically.
• Psychosocial: It triggers anxiety and causes social isolation.
• Economic: In low-resource areas, treatment costs can consume half a family's annual income, driving households into poverty.

Reversing this crisis demands a fundamental shift, with diagnostics serving as the most powerful catalyst for change. This very shift was the focus of the 2nd Asia Pacific-International Roche Infectious Disease Symposium (APAC-IRIDS 2026), held in Bangkok in July, which gathered over 100 clinicians, lab leaders and public health experts from across the region to examine how integrated diagnostic strategies can move health systems from passive response to proactive prevention – especially for TB, one of Asia-Pacific's most entrenched threats.

Bringing the discussion back to China, the country has made significant strides. In 2024, China has dropped from third to fourth place among the 30 high TB burden countries, and its incidence rate has entered the lower moderate-burden category for the first time, highlighting China's contribution to global TB control and prevention. However, this progress remains fragile and uneven, and a significant gap remains in achieving the ambitious goal of ending the TB epidemic.

In a post-event interview, Professor Lu Shuihua, Chairman of the Committee of the Tuberculosis Branch of the Chinese Medical Association, stressed that strengthening early screening, accurate diagnostics, and standardized treatment is essential for further reducing China's TB incidence and improving overall public health outcomes.

"Beyond newly confirmed TB patients, an estimated 350 million people nationwide live with latent TB infection," Lu noted. "To achieve timely and precise diagnosis, we are advancing integrated screening solutions that combine AI-powered X-ray imaging analysis with high-precision molecular testing. Enhanced governmental intervention, upgraded clinical protocols, and widespread public health education are all indispensable to curb TB transmission. The National Tuberculosis Prevention and Control Plan (2024–2030) identifies two strategic priorities: active case finding and expanding preventive treatment coverage among individuals with latent TB infection to 80 percent by 2030. These measures are intended to narrow the diagnostic gap and accelerate progress toward elimination."

Laboratory testing influences nearly 70 percent of clinical decisions and is the most utilized medical benefit in healthcare, yet accounts for only 2 to 3 percent of total healthcare expenditure, reflecting a structural imbalance that hinders global disease control efforts. High-throughput population screening, rapid biomarker detection, and precision molecular testing enable early identification of hidden infections, support standardized hospital antibiotic stewardship, and transform clinical uncertainty into targeted, reliable care.

In China, one such tool already available is the cobas® MTB test – a fully automated, real-time PCR-based molecular assay that runs on the cobas® 5800/6800 systems. Approved by China's National Medical Products Administration (NMPA) in January 2026, it is designed to directly detect Mycobacterium tuberculosis complex DNA from sputum samples with high sensitivity and specificity.

To drive regional public health transformation across the Asia-Pacific, Roche Diagnostics is evolving beyond its traditional role as a medical device supplier, growing into a dedicated prevention leader and trusted healthcare partner for laboratories, clinical networks, and government health authorities.

This shift mirrors what Chinese experts have long advocated. As Professor Lu noted, "We must proactively build a comprehensive strategy to move the defense line forward – from treating disease to preventing it. Early screening, precise diagnosis, and timely intervention are the keys to truly ending TB."

As the Asia-Pacific continues to address long-standing infectious disease challenges, advanced diagnostics will remain the cornerstone for closing detection and treatment gaps, advancing Sustainable Development Goal 3, and ultimately ending the global tuberculosis epidemic by 2030.