The emergence of drug-resistant TB remains a global health threat, with only one-third of individuals estimated to have multi-drug (MDR) or rifampicin-resistant (RR) TB diagnosed and treated annually. While culture-based methods remain the standard for drug susceptibility testing (DST), they are not widely available and have long turnaround times for results, resulting in delays in diagnosis, treatment failure, and ongoing transmission of resistant strains. In 2023, the WHO recommended using targeted next-generation sequencing (tNGS) for detecting and managing drug-resistant TB. ASLM organized a four-part series to help countries share best practices for implementing tNGS. In the final session of the series, Dr. Bony Lestari presented lessons learned from a Gates Foundation-funded project that was implemented in West Java, Indonesia. The results showed that tNGS enhanced the diagnosis and management of patients with drug-resistant TB. However, the cost of implementing tNGS was approximately twice that of phenotypic DST, suggesting that programs would need to carefully assess their diagnostic networks and local TB epidemiology to strategically integrate tNGS where it will have the greatest impact. Please follow the links here to view the recorded ECHO session and download the presentation slides.