Background:

Tuberculosis is the pandemic causing the highest death toll in humans.

Aim.

To warn on the incongruities that limit an approximation to the real knowledge of tuberculosis, and may favor its spread in the COVID-19 times.

Development:

Six incongruities are hindering real knowledge of the disease: a) underestimation, b) exclusive occurrence in poor settings, c) underestimation of the zoonotic elements of the Mycobacterium tuberculosis complex, d) underrating of the animal reservoirs, and f) detachment between the current molecular taxonomy and the previous limitations. The factors that contextualize it can alter its real status, and delayed the decisions necessary for its eradication until 2018. Since 2020, almost the absolute subordination of health systems to COVID-19 interfered with that purpose and may cause a setback of tuberculosis to a situation similar to 2012. Though scarce, studies on possible synergies between the two pandemics predict that coinfected patients are 2.21-2.27-fold more likely to die or develop a serious disease.

Conclusions:

Tuberculosis is the oldest and most lethal pandemic to humanity; it is also the most commonly ignored. It has been caused by overconfidence, underestimation of the least favored areas of the planet, the participation of animals, the environment, and the absence of a proper state-of-the-art taxonomic knowledge to tackle these threats. This situation has been aggravated by the priority demanded by COVID-19. A first step to achieve its eradication in the future would be to assess the incongruities that hindered the existence of more objective knowledge of tuberculosis.