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The case of Microscopic-Observation Drug-susceptibility (MODS) testing for Multi-Drug Resistant and Extreme Drug Resistant Tuberculosis in Thailand raises issues of equity, as it provides benefits to both individual patients and the wider population. A cost-benefit analysis showed that MODS costs the same as the current standard TB testing practice but provides greater benefits, particularly in identifying extreme drug-resistant forms of the disease quickly. However, the policy decision was not to adopt the new testing regime due to limited system capacity and the small number of patients affected by drug-resistant forms of TB, despite the high cost of treating them. MODS is a low-cost, low-tech tool that can detect TB, MDRTB, and XDRTB, with a time to culture positivity of around 6 days, compared to 4-8 weeks for the conventional test. Studies have found that MODS detects TB with greater sensitivity and speed and reliably identifies multidrug-resistant tuberculosis strains in significantly less time than the conventional test. In Thailand, the current approach often misses half of all drug-resistant forms of TB, and treatment failure is used to prompt testing for MDRTB, which can lead to the spread of the disease. Early diagnosis and effective treatment of MDRTB can prevent the disease from developing into XDRTB, reduce morbidity and mortality, and improve quality of life for patients.