In spite of the Covid-19 pandemic, TB is now the “top infectious disease killer in the world.” In 2019, as many as 10 million individuals produced TB and 1.4 million were killed. Why, then, have we never seen the kind of mobilisation for TB we see for Covid-19 in all these years of working on the issue? The answer to this is simple, TB tends to be seen among infectious diseases as the ‘poorer relative’ as it affects only the developed world. It only affects the poorer people in developing countries that are often lost among the bad healthcare system and medical reach. The sudden attention on Covid-19 has had a major negative effect on tuberculosis response worldwide, probably more than other diseases, as the Covid-19 response has been based on or used for the tuberculosis response worldwide. This meant that TB programmes were ‘re-proposed’ in many countries, including India, to support the Covid-19 response, using the personnel and facilities of the TB programme, which meant that these services were not available to people with or at risk of TB. COVID-19 and TB have many similarities as well as differences. Both affect the elderly and have associated comorbidities. 

In addition, the economic impact due to loss of production and devastating costs for individuals and families, major social impacts such as stigma, prejudice, and alienation are correlated with both diseases. There are some major distinctions between the two as well. Over the past three decades, TB has been labelled as a pandemic several times, though this is the first COVID-19 pandemic. Children are mostly less seriously affected by COVID-19, while 1 · 1 million children had TB disease in 2018, and it is estimated that about 3,42,000 paediatric TB events occur annually in India, accounting for 31 per cent of the global burden y as per the India TB Study 2019.

Machines used to test for TB in India, such as TrueNat and CBNAT machines, have been redirected to test for Covid-19. The additional difficulty is that Covid has been related to a lot of recent funding calls. If funding is to promote the Covid response, this could also be used to develop capacity and improve the TB response in terms of access to diagnostic tools, infection management steps, contact tracing, respiratory symptom screening, as both TB and Covid-19 are similar. It is important to restore TB facilities to pre-Covid levels as soon as possible and to intensify successful case-finding efforts in order to identify and treat missing patients. As for the restoration of TB facilities, anecdotal evidence and notification data still indicate that India has not returned to the extent of pre-Covid TB  detection.