INTRODUCTION:
The TB health system optimization initiative introduced an innovation-driven approach to redesign TB service delivery toward a more integrated, patient-centered, and digitally enabled model. The High-Level Meeting in 2025, co-organized by WHO at three levels (HQ, WPRO, Country Office) and the Government of Mongolia, brought together MOH, NCCD, NGOs, academia, and PHC representatives to align on a shared innovation agenda. Key innovations discussed included the integration of TB services into PHC through digital triage and referral systems, linking diagnosis, treatment, and follow-up in real time. The workshop emphasized leveraging AI-assisted digital X-ray screening, molecular diagnostic expansion, and e-TB registries to improve case detection efficiency. Participants explored innovative financing mechanisms, such as performance-based contracting and insurance reimbursement models, to ensure sustainable service delivery. Multisectoral engagement was recognized as an innovation in governance, linking social protection, labour, and health systems to address the socioeconomic determinants of TB. The meeting highlighted the importance of rethinking the health workforce model through PHC-TB. Overall, the innovation lens within TB health system optimization was framed as a pathway to achieve efficiency, equity, and sustainability—aligning Mongolia’s TB response with the goals of Universal Health Coverage and the End TB Strategy by 2035. Result/benefit: The innovation will improve early TB detection and timely treatment through decentralized diagnostic services and strengthened PHC integration. Surveillance accuracy, workforce capacity, and community engagement will be increased, leading to reduced transmission and better treatment outcomes. Overall, these improvements will make TB services more accessible, efficient, and sustainable toward achieving a TB-free Mongolia.