In Brazzaville, the capital of the Republic of the Congo, Salomon, a man in his 30s, anxiously hands over his laboratory test results and a lung X-ray to Amélie Makoundou, a public health assistant at the Brazzaville Tuberculosis (TB) Centre. After carefully examining the documents, Makoundou reassures him, “It’s okay, you’re cured.” At first, Salomon remains impassive, as if struggling to process the news. She repeats, “You can stop treatment, you are cured.” Finally, a broad smile spreads across his face as he thanks Makoundou and leaves, completing six months of arduous treatment.

A Revolution in Tuberculosis Diagnostics

Diagnosis is the cornerstone in the fight against TB, enabling early detection and treatment. Recognizing this, the Republic of the Congo, with support from the World Health Organization (WHO) in the African Region, has prioritized laboratory capacity-building as a central pillar of its TB elimination strategy.

In 2013, Congo acquired its first GeneXpert machine, a critical tool for the rapid detection of TB bacteria. However, due to limited laboratory infrastructure, the country had to send samples abroad for mycobacteria culture and antibiotic resistance testing, often waiting six to eight months for results.

“This situation significantly delayed the treatment of patients with multidrug-resistant tuberculosis,” explains Dr. Darrel Ornelle Elion Assiana, Director of the National Mycobacterial Reference Laboratory (NMRL). “Without timely culture results, we couldn’t even confirm whether patients were cured at the end of their treatment.”

Expanding Capacity and Reducing Delays

With WHO’s support, resources were mobilized through the Global Fund, leading to the acquisition of a modular microbiological safety laboratory in 2018. The NMRL now boasts 46 GeneXpert machines, supporting a network of 113 testing and treatment centers across the country’s 12 departments.

By 2024, Congo had been classified as a high-burden TB country with a mycobacteria reference laboratory that meets WHO standards. The NMRL not only facilitates screening but also offers advanced diagnostics, including microscopy, culture, anti-TB drug sensitivity tests, and molecular diagnostic tools such as genomic surveillance.

“Today, results of susceptibility tests are available within two weeks, or a month at most,” says Assiana. “For genotypic susceptibility tests, results come within 24 to 48 hours, allowing for timely initiation of the most effective treatments.”

The Vital Role of Public Health Workers

On the frontlines of this battle against TB is Amélie Makoundou, who has spent nearly 30 years treating patients. She sees about 50 individuals daily, each requiring accurate diagnosis before treatment can begin.

“I’m the one who sends the patient to the laboratory,” she explains. “We cannot put anyone on treatment without a lab result. How else can we ensure they receive the right care?”

Her question underscores the critical role of laboratory testing in combating TB, a disease that claimed over 400,000 lives in the WHO African Region in 2023, with 1.9 million new cases detected, including 14,370 in Congo alone.

Global Support Driving Congo's TB Response

WHO and its partners are actively strengthening Congo’s diagnostic capabilities, enhancing the National TB Reference Laboratory, and training local technicians. An international laboratory consultant has been deployed to provide technical support, ensuring that standards remain high.

“WHO prioritizes laboratory infrastructure as it is essential for rapid disease detection,” states Dr. Vincent Dossou Sodjinou, Acting WHO Representative in Congo. “Timely diagnosis helps clinicians start treatment quickly, ultimately saving lives. Ending TB is crucial for public health, economic growth, and overall well-being.”

Thanks to these efforts, 41% of new TB cases are now diagnosed using WHO-recommended rapid testing methods. Between 2022 and 2023, TB case detection increased by nearly 5%, while the number of patients initiating treatment for drug-resistant TB more than doubled, from 231 to 494. Preventive treatment also expanded, with over 1,700 individuals receiving prophylactic care in 2023—a 46% increase from the previous year.

The Laboratory as the Key to Treatment Success

“It is through the laboratory that we identify the TB bacterium and assess its resistance to treatment,” says Professor Franck Hardain Okemba-Okombi, Director of the National Tuberculosis Control Programme. “Even after treatment begins, it is the lab that confirms improvement and determines the treatment duration.”

Congo’s treatment success rate rose to 82% in 2022, up from 72% in 2019, reflecting significant progress in TB management. For Makoundou, each patient’s recovery is a personal victory.

“It’s an indescribable feeling when a patient completes treatment and is declared cured,” she says. “Every cure is a step forward in the fight against tuberculosis.”