IOM implemented 2 waves of TB REACH funded project from December 2011 to March 2016 aiming to improve Tuberculosis case detection in nine districts through (a) Laboratory testing with point of care GeneXpert instrument and (b) improving referral of TB testing from periphery level microscopic centres. Implemented in close collaboration with National TB Program and funded through WHO Stop TB partnership, the project reached out to most vulnerable groups such as labour migrants and people living with HIV and AIDS. With this project, IOM introduced GeneXpert technology, a breakthrough in rapid diagnosis of TB for the first time in Nepal from 8 selected GeneXpert centers. The project successfully tested a total of 52,662 TB suspects with GeneXpert and detected nearly 10,000 TB cases with 596 Rifampicin Resistant cases. Likewise, IOM also supported to develop a national algorithm for GeneXpert in Nepal in consultation with NTP and other local partners working in TB in Nepal and build the capacity of the Government to scale up this technology. As of now, NTP has revised the previously developed guideline and expanded GeneXpert technologies in more than 50 centers on Nepal. Similarly, IOM supported one national level organization to implement a project entitled “Strengthening referral mechanism from private sector for early and active case findings of Tuberculosis”, among OPD patients of private health sector of 6 districts of Eastern Nepal namely; Morang, Jhapa, Sunsari, Saptari and Udaypur from September 2014 to December 2015 (16 months). A total of 148,614 patients visiting OPD of 40 selected hospitals were screened, 15,972 presumptive TB cases were identified, tested for sputum for 15,935 cases, and 1,475 TB patients were identified using smear microscopy and GeneXpert testing and enrolled in treatment. The outcome of this project, worked as a base for NTP to develop PPM strategy to identify hidden TB cases and improve case notification.