Following gargantuan global efforts against COVID-19, tuberculosis (TB) is once again the world's biggest infectious killer, a top expert has told AFP, lamenting the lack of focus on rooting out TB.

Mel Spigelman, president of the nonprofit TB Alliance, hailed the swift and dramatic progress to rein in the ­COVID-19 pandemic, with a vast array of safe and effective vaccines, tests and treatments developed in the space of two years. "But the juxtaposition with TB is pretty stark," he said in an interview.

TB, once called consumption, was the world's biggest infectious killer before the arrival of COVID-19, with 1.5 million people dying from the disease each year.

With global COVID-19 deaths steadily declining, "TB has regained the dubious distinction," Spigelman said.

The TB Alliance, a nonprofit working to develop and deliver faster-acting and affordable drugs against the disease, especially in poorer countries, points out that based on the annual death rate, TB kills 4,109 people a day.

That compares to 1,449 people a day dying due to ­COVID-19, calculated from the 40,578 deaths reported in the past 28 days on the Johns Hopkins University dashboard.

But unlike COVID-19, there appears to be little, and even waning, interest in taking on TB.

In fact, the pandemic had a devastating impact on efforts to battle TB, with TB hospitals taken over for COVID-19 care, and lockdowns preventing patients from coming in for diagnosis and treatment.

As a result, the number of annual TB deaths swelled for the first time in a decade back in 2020.

"We went from what I honestly consider to be unbelievably slow progress, but at least progress, to a reversal," Spigelman said. "It has been a major setback." 

While billions of dollars were being thrown at the ­COVID-19 fight, global economic woes and swelling geopolitical tensions prompted top donors toward the TB battle to tighten their purse-strings for the time being.

Most of the TB Alliance donors suddenly could not ­commit more than a year of funding at a time and slashed the amounts given, with traditional top donor Britain ­providing no funding at all in 2022.

"I am very worried that the progress that has been made, which has already been eroded by COVID... could be even further eroded," Spigelman explained.

Spigelman blamed the lacking urgency around rooting out TB on it being "a disease of the poor."

"If rich people around the world were getting it, I think we would see a very different response," he said.