Monde Muyoyeta couldn't wait to become a pediatrician. Growing up in Zambia, she spent her childhood hunched over a dog-eared medical encyclopedia, fascinated by all the images of the human body. That fascination carried her all the way through medical school and her first job as a physician. But, around 2000, her dream got caught up in the doctor's strike over poor working conditions and little pay. In response, the Zambian government suspended most of the junior doctors in the country, including Monde. They were later reinstated, but with limited opportunities to pursue further studies in specializations like pediatrics, Monde decided to move to the UK. While studying for her UK medical licensing exams she got a job working for a tuberculosis researcher, planning to only work for a year or two until she passed her exams.

Today, she is one of Zambia's top public health experts on tuberculosis.

"I very quickly realized that you have a larger impact doing public health type work, and in Zambia where we still have a lot of issues with preventable diseases you want to be intervening at a preventive level," said Monde. "The rest is history."

For a long time, TB diagnosis was dependent on smear microscopy, an economical and quick method that also failed to catch cases, especially among HIV patients. In 2011, Monde's team was the first in Zambia to introduce the GeneXpert, a new molecular diagnostic test that was much more precise, in public health facilities. But the GeneXpert machine was also more expensive, and the cartridges used a lot of storage space - all of which complicated its initial implementation. For example, due to its high cost, only a handful of machines were purchased and placed in central-level health facilities. Local clinics began relying only on the Xpert test and stopped using smear microscopy entirely. But after sending their samples, they had to wait up to a week for the results, leading to delayed diagnoses.

"We put the machines in these facilities, but nobody was talking about access," said Monde, whose PhD research focused on improving access to diagnostic tests. "For me, that was interesting. You can come up with all these wonderful diagnostics, but if you're not dealing with the inherent barriers, you actually have minimum impact."

Her work has helped explain how diagnostic tools can be used most efficiently in real-world settings. For instance, her study on the use of GeneXpert in resource-constrained settings evaluated two algorithms that suggested which patients should get the Xpert test and which should suffice with a smear microscopy. The results helped increase confirmed TB diagnoses while minimizing overuse of the expensive test.

In 2024, Monde became chief scientific officer at the Centre for Infectious Disease Research (CIDRZ) in Lusaka, Zambia, allowing her to apply her vast research experience in TB to shape the organization's overall research agenda. Her top priority is to broaden CIDRZ's work beyond implementation research to also include basic science and immunology research capacity, so local scientists don't have to leave Zambia to develop new products, vaccines, and treatments.

Monde's current project - or what her younger colleagues affectionally call an obsession - is to construct CIDRZ's first basic science lab by the end of 2026. She is already busy lobbying for investment in equipment for the lab.

"I think you need to have a little bit of obsessive behavior to be successful in what we do. Because to achieve anything you must keep at," she said.