As Kerala progresses towards achieving the SDG goal of TB elimination, enhancing the diagnostic network with a robust sample transportation system is crucial. Annually, Kerala reports proximately 22,000 TB cases. Like any health programme, the success of NTEP starts with affordable and accessible high-quality lab services. A key pillar in diagnostics is ensuring a quality sample reaches the testing site in proper form and on time. Unfortunately, despite having the capacity to conduct around 50,000 NAAT tests per month, challenges in proper sample collection and transportation lead to underutilization of NAAT sites. Situation is more concerning at the level of Intermediate Reference laboratory and Culture and Drug sensitivity laboratories where the samples are not delivered at right time and at right temperature.

• One significant challenge is the non-availability of adequate packing materials at affordable rates, affecting the quantity and quality of samples reaching the NAAT sites and high-end laboratories at Thiruvananthapuram (Intermediate Reference Laboratory) and Kozhikode (C& DST Laboratory). This results in missed opportunities for microbiological confirmation of TB and diagnosis of drug-resistant TB. According to National TB Elimination Programme guidelines, samples from all diagnosed TB patients must undergo advanced testing for early detection of drug resistance and to monitor treatment response at two Biosafety Level 3 labs: the Intermediate Reference Laboratory in Thiruvananthapuram and the Culture & DST Laboratory in Kozhikode. However, due to a shortage of items and funds for procurement, the quality of TRIPLE LAYER PACKAGING as recommended by WHO and NTEP guidelines is compromised. This inconsistency compromises the timely delivery of quality test reports, potentially leading to missed or delayed diagnoses of drug-resistant TB, contributing to fatalities and posing risks to individuals handling samples.
• SSREE Foundation acts as the implementing agency with the support of the firms closely engaged with the diagnostic network, is best positioned to understand and meet the critical need for TB elimination in Kerala , to act on the first and key action area—sample collection and packing as per recommended standards —by providing the state with items required for proper sample transportation.