**5. Conclusions**

The health and economic crisis created by the current COVID-19 pandemic, as well as the public health measures taken to stop the spread of the virus, could have a potential impact on TB prevention and control in many different ways. The proportion of the cumulative disease burden associated with the COVID-19 pandemic due to failures in endemic disease managemen<sup>t</sup> might end up being greater than that directly caused by COVID-19 itself. It is essential that health systems attempt to maintain routine services for endemic infectious diseases to the highest level possible, recongizing that this may, through necessity, be lower than pre-pandemic levels. It is also essential that health systems have a plan for returning to full service levels as soon as possible, in particular for controlling major endemic diseases such as TB. Economic analyses of the impact of the pandemic should include indirect effects

like disruption to routine services and subsequent burden of TB and other endemic infectious diseases. Public health vigilance is necessary to mitigate the impact of COVID-19 on TB prevention and control, with plans in place to manage any increases of TB burden in future years.

**Author Contributions:** K.A.A., A.C.A.C., and K.W. conceived the study; K.A.A. drafted the manuscript; A.C.A.C. and K.W. were involved in the critical revision of the manuscript. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research received no specific gran<sup>t</sup> from any funding agencies in the public, commercial or not-for-profit sectors.

**Conflicts of Interest:** The authors declare no conflict of interest.
