Impact assessment of diagnostic tools for multi-drug resistant and (MDR-TB) drug sensitive tuberculosis (TB) in the Philippines While the Philippines has made great strides in Tuberculosis (TB) control, it continues to be the 6th largest cause of mortality and morbidity in the country. There are around 27,000 deaths annually and an estimated 290,000 new cases of TB each year at an incidence rate of 292 per 100,000. The percentage of TB cases with Multi-drug resistance (MDR-TB) is 2% for new cases and 21% for retreatment cases. The World Health Organization (WHO) estimate that only 12-16% of actual MDR-TB cases are detected of which only two-thirds are successfully treated. In the largest province in the country (Cavite) case detection rates have been improving, however only 35% of the estimated smear-positive MDR-TB cases are currently detected.   Improvement in access to accurate diagnosis is necessary to reduce further the burden of TB/MDR-TB. Encouragingly there is a pipeline of new diagnostic tools becoming available. For example, Xpert MTB/RIF is a new technology recommended by the World Health Organization that has the potential to make a significant difference to diagnosis of TB and MDR-TB in high burden countries like the Philippines. At the present time there are just 16 sites that perform the Xpert MTB/Rif test scattered over the different regions of the country. If the benefits of these developments are to be realized in the Philippines it is essential an appropriate strategy on scale-up is developed. However, more work is needed on the data to go beyond test accuracy in order to promote rational, evidence-based decision-making on uptake and implementation. TB diagnostics are not implemented in isolation, but are always part of an algorithm that operates in conjunction with other diagnostic approaches, such as empirical treatment or radiology. Computer modelling is an approach that can bring together the published and national data to provide policy makers with the evidence they need to support rational decisions.  In this study a number of alternative diagnostic options will be researched using an innovative modelling approach to project patient and health system outcomes including understanding the cost effectiveness of alternative options. Working with the National TB programme (NTP) of the Philippines these projections will be used to develop a strategy on scale up of new diagnostics in the largest province of the Philippines (Cavite). Filipino researchers from the De la Salle Health Sciences Institute (DLSHSI) will also be trained and equipped to conduct research in other provinces and on other diagnostic tools as they become available.   Our aim is to equip Filipino researchers and the NTP of the Philippines with a tested impact assessment approach that can be used to project the impact of new diagnostic tools and algorithms for MDR-TB and TB. Thus enabling policy makers to make rational and appropriate decisions on the scale-up of new diagnostic tools across the country. The approach used in this study has the potential to be applied in many other contexts around the world where TB and MDR-TB is a major barrier to public health and therefore economic development. The Newton Fund builds research and innovation partnerships with developing countries across the world to promote the economic development and social welfare of the partner countries.