Global policy perspectives on digital tools for the tuberculosis diagnostic pathway: a qualitative study

Objectives. This study examined how global policy stakeholders view the potential of digital tools for tuberculosis screening and triage. A smartphone-based application using cough audio for triage, which is currently under development, was utilized to inform the discussion and generate insights relevant to the broader adoption of digital health technologies in settings with a high tuberculosis burden. Design. Qualitative, semi-structured interviews were conducted online with fifteen experts involved in tuberculosis screening, triage, and diagnostic evidence and policy at global level. Interviews were transcribed verbatim and analysed thematically. Results. Participants viewed digital tools as having the potential to strengthen the tuberculosis diagnostic pathway by reducing administrative workload, supporting earlier case identification, and offering more discreet and accessible entry points into care. At the same time, they identified persistent barriers to implementation, including limited infrastructure, funding constraints, gaps in digital literacy, and the absence of clear governance frameworks. Participants emphasised the importance of human-centred design, context-specific adaptation, and equitable access. Conclusions. Digital tools hold promise for optimizing the tuberculosis diagnostic pathway in high-burden settings, but their effective integration requires coherent policy guidance, investment in infrastructure and workforce capacity, and design approaches that support usability and equity.