Supporting, Mobilizing, and Accelerating Research for Tuberculosis Elimination is a five-year initiative made possible by the United States Agency for International Development (USAID), with the assistance of the American people, that aims to transform TB prevention and care. In 2021, an estimated 10.6 million people fell sick with TB worldwide, and 1.6 million died, making it second only to COVID-19 as leading infectious disease killer. SMART4TB will design and implement research studies with local partners to identify effective person-centered methods for finding, treating, and preventing TB; strengthen local capacity to conduct high-quality research; and engage communities to build demand for new interventions, drive policy change, and improve implementation of new and existing interventions to reach the End TB targets.

how smart4tb works

SMART4TB has six guiding principles that shape everything from how partners are engaged to how resources are utilized to produce results that drive impact.

  • Transformative – novel approaches for reducing TB burden
  • Inclusive – engaging Ministers of Health and National TB Programs, local partners, and affected communities at all steps of the research to policy continuum
  • Collaborative – Providing support and processes for locally-led research
  • Transparent – Using a transparent and unbiased process for selecting studies in partnership with USAID
  • Supportive – Intentional support for developing the next generation of TB scientists
  • Synergistic – Harmonizing with other USAID resources, including Global Accelerator to End TB and other programs, and leveraging support from product developers and sponsors


The SMART4TB Consortium brings together experts in TB tools development, implementation science, capacity strengthening, civil society engagement, and policy translation. Led by Johns Hopkins University, consortium partners include Elizabeth Glaser Pediatric AIDS Foundation, KNCV Tuberculosis Foundation, Treatment Action Group, and University of California, San Francisco.

Current SMART4TB activity is taking place in the countries noted above. SMART4TB will work in 24 USAID priority countries for TB including: Afghanistan, Bangladesh, Burma, Cambodia, Democratic Republic of Congo, Ethiopia, India, Indonesia, Kenya, Kyrgyzstan, Malawi, Mozambique, Nigeria, Pakistan, Philippines, South Africa, Tajikistan, Tanzania, Ukraine, Uganda, Uzbekistan, Vietnam, Zambia, and Zimbabwe. SMART4TB could potentially work in other countries including the 32 countries that are eligible for Global Fund technical assistance, including: Angola, Armenia, Azerbaijan, Belarus, Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Côte D’Ivoire, Eswatini, Georgia, Ghana, Guinea, Haiti, Kazakhstan, Lesotho, Liberia, Madagascar, Mali, Moldova, Morocco, Nepal, Niger, Pakistan, Papua New Guinea, Republic of Congo, Rwanda, Senegal, Sierra Leone, Somalia, and South Sudan.

To learn more and find out how your organization can get involved, contact

what smart4tb does

SMART4TB has constructed a coordinated and integrated approach to developing the activities of seven technical areas (TAs), from diagnostic research to policy advocacy. Read more about each TA below.

Technical Area 1 Diagnostics

Diagnosis is the entry point for TB care, and underdiagnosis is one of the main drivers of the TB epidemic. Accessible, timely TB diagnoses are currently beset by tests that are expensive, infrastructure-intensive, do not detect TB well in samples other than sputum, and do not predict the likelihood of developing active TB. SMART4TB aims to address these gaps by identifying novel diagnostics for field evaluations and World Health Organization policy review. Learn more.



Technical Area 2 Therapeutics

While major strides have been made recently in shortening treatment for some populations, many have been left out. SMART4TB will focus on developing optimized treatment for both drug-susceptible and drug-resistant TB, including often neglected childhood TB. Learn more.

Technical Area 3 Operational Research

Operational Research will involve working with local partners in USAID priority countries to develop and implement operational research studies to improve performance of TB programs. SMART4TB will assist and support local investigators in developing research protocols to address key needs in program effectiveness. Because this TA will be driven by national and local priorities and ideas, plans are still in early-stage development as SMART4TB begins to forge partnerships with country stakeholders.

Technical Area 4 Interrupting Transmission

A large proportion of TB transmission occurs among non-household contacts, often through casual interactions in high-risk community settings. SMART4TB wants to develop research studies that look at ways to effectively interrupt community transmission and work with Diagnostics and Therapeutics to understand how airborne infection prevention and control can be adapted as part of local research implementation.

Technical Area 5 Vaccine Preparedness

As the first promising TB vaccine candidates in over a century approach late-stage trials, SMART4TB will complement their clinical development by studying regulatory licensing, and preparing for widespread adoption, scale-up, and sustaining a new vaccine within health systems. SMART4TB wants to examine recent vaccine introductions across the life course and collect data in USAID priority countries on both vaccine demand and the health system readiness to support eventual new vaccine introduction. Learn more.

Technical Area 6 Capacity Strengthening

This area is focused on supporting TB research that is informed by local communities’ needs and that can be translated into life-saving policy changes. SMART4TB will work with stakeholders in priority countries to understand and meet their support and training needs, both through targeted programs like Early Stage Investigators and larger training opportunities. Learn more.

Technical Area 7 Policy Translation

A cross-cutting area of work that supports all the other TAs through coordinating community engagement in the design and implementation of SMART4TB research and preparing for eventual policy translation of SMART4TB findings. TA7 will work with both affected communities and policymakers to attain high-level global policy commitments to advance research and care to end TB and create accountability for those commitments. Learn more.

LEARN MORE Still have questions? Visit our Frequently Asked Questions.

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SMART4TB is made possible by the support of the American people through the United States Agency for International Development (USAID). The contents of the website are the sole responsibility of SMART4TB and do not necessarily reflect the views of USAID, the United States Government, or consortium collaborators or members.