MODS and TLA assays are inexpensive, rapid alternatives to conventional methods for drug susceptibility testing of M tuberculosis. Our data and expert opinion informed WHO's recommendation for use of selected non-commercial drug susceptibility tests, including MODS, as an interim solution until capacity for genotypic or automated liquid culture drug susceptibility testing is developed.

More than half a century after the discovery of effective drugs, tuberculosis remains an intractable foe. In 2008, 1·8 million people died from the disease, half a million of whom also had HIV.1 Each year an estimated half a million multidrug resistant (MDR) tuberculosis cases develop, of which around only 7% are diagnosed.2 In the 27 high-burden countries for MDR tuberculosis, because of a lack of laboratory capacity only 1% of new patients received testing for drug susceptibility in 2008.2 There is an urgent need for rapid diagnostics for use in high-burden and resource-limited settings.

Schistosomiasis is a major neglected tropical disease, with more than 200 million people infected and close to 800 million at risk. The disease burden is estimated to exceed 70 million disability-adjusted life-years. The anthelmintic drug praziquantel is highly effective in killing adult schistosome worms, but it is unable to kill developing schistosomes and so does not prevent reinfection. As a result, current praziquantel-based control programmes in Asia and sub-Saharan Africa are not effective or sustainable in the long term.