Over the past decade, several new options for improving TB diagnosis have become available. The past year saw considerably more progress than the previous one. However, the reality of how most TB is diagnosed—or not—remains largely unchanged. The world failed to detect 3.6 million of the estimated 9.6 million new cases of TB in 2014. Sputum smear microscopy—which misses over half of TB cases and gives no indication of drug susceptibility to guide appropriate treatment—is still the diagnostic standard in most of the world, despite the availability of the far more sensitive GeneXpert MTB/RIF for six years. Late in 2015, the World Health Organization (WHO) approved Alere's TB lipoarabinomannan (LAM) test—a very affordable, simple, rapid, noninvasive, point-of-care (POC) rule-in test for people with HIV with very low CD4 counts—but no country has begun to implement it yet. New versions of line probe assays—Hain's MTBDRplus and MTBDRsl and a product from Nipro—received WHO recommendation, facilitating rapid drug susceptibility testing (DST), but the world is still a long way from universal DST, with an estimated 59 percent of cases of multidrug-resistant TB (MDR-TB) undetected.