In response to Ukraine’s high burden of tuberculosis (TB), particularly multidrug-resistant tuberculosis (MDR-TB), the World Health Organization (WHO) Ukraine in collaboration with the WHO Supranational Tuberculosis Reference Laboratory in Gauting, Germany, has intensified efforts to fortify the country’s TB diagnostic infrastructure. These efforts focus on drug resistance surveillance and expanding access to WHO-endorsed rapid TB diagnostic technologies.

Ukraine remains a priority country in the WHO European Region for TB control and is one of only nine countries globally with a high incidence of MDR-TB. Prompt and effective treatment depends on timely and accurate diagnosis, which is achievable through rapid molecular diagnostics and reliable drug susceptibility testing (DST) in line with WHO-recommended protocols.

Field Evaluation and Capacity-Building

Between July and August 2023, WHO led a technical mission to Ukraine, financially supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria. The mission involved a comprehensive review of regional TB laboratory services, with the following key objectives:

• Introduction and scaling of rapid diagnostic methods for TB and MDR-TB
• Assessment of diagnostic quality and laboratory readiness for ISO 15189 accreditation
• Capacity-building through on-site training of laboratory personnel

Despite ongoing conflict and repeated assaults on healthcare infrastructure, international experts commended Ukraine’s national TB program and laboratory professionals for their resilience and continuous modernization of diagnostic operations.

“Ukraine’s TB laboratory services have achieved substantial modernization in recent years. Even under wartime conditions, laboratories are integrating state-of-the-art diagnostic technologies” stated Evgeni Sahalchyk, a TB diagnostics specialist from WHO’s Supranational Reference Laboratory.

Site Visits and Laboratory Strengthening

The WHO team visited several critical diagnostic facilities, including:

• The Reference Laboratory of the Public Health Centre of Ukraine, which focuses on TB and high-risk pathogen diagnostics
• Regional TB laboratories in Kyiv and Khmelnytsky

Based on the mission’s findings, the following strategic priorities were established:

1. Implementation of WHO Guidelines

• Support for the integration of WHO-endorsed TB diagnostic algorithms at national and regional levels
• Development of standardized record-keeping and reporting frameworks

2. Biosafety and Quality Management

• Technical assistance in meeting international biosafety standards
• Establishment of laboratory-wide quality management systems (QMS)

3. Quality Assurance

• Introduction of external quality assessments (EQA) and reinforcement of internal quality controls (IQC) for microbiological TB diagnostics to ensure data accuracy and reproducibility

4. Human Resource Development

• Expansion of training programs and technical mentoring to enhance workforce competency in TB diagnostics

5. Strategic Planning and Accreditation

• Support in the development of long-term strategic plans for laboratory system strengthening
• Guidance through the process of ISO 15189 accreditation, aimed at formalizing diagnostic excellence

Sustained Support in Crisis and Recovery

Continued technical and strategic support from WHO and its Supranational TB Reference Laboratory will remain pivotal throughout the conflict period and during post-war recovery. Ukraine’s objective is not only to rehabilitate its healthcare infrastructure but also to build a stronger, more resilient diagnostic system that can respond to current and future infectious disease threats.

Reference:
World Health Organization (WHO) Europe. (2023, September 8). WHO strengthens tuberculosis control in Ukraine using high-quality diagnostic methods. Retrieved from https://www.who.int/europe/news/item/08-09-2023-who-strengthens-tuberculosis-control-in-ukraine-using-high-quality-diagnostic-methods