But a declaration of a TB emergency in Africa "will certainly help tackle the problem," Candido Mindu, head TB doctor at Maputo's busy Machava hospital, said Friday, a day after African health ministers meeting in his capital declared the emergency and promised to commit more money and staff to detecting and treating the disease.

The ministers at a World Health Organization regional meeting also appealed to donor governments to plow more resources into what is regarded as one of the world's most forgotten diseases. WHO's Stop-TB department has called for US$2.2 billion (€1.8 billion) in new funding for TB control in Africa during 2006-2007, saying that TB expenditure is dwarfed by spending on HIV/AIDS.

Facing Up to a Horrendous Situation

TB is killing more than half a million people a year on the world's poorest continent. In Mozambique, 30,000 cases were diagnosed in 2004, but this is likely to be an underestimate because many people in rural areas are unable to seek treatment, said Mozambique's Deputy National Director of Health Martinho Djedje.

"It's really a worry for our country," said Djedje. "We need to check what is happening in the rural areas, but due to problems like poor roads we can't."

TB is spread by airborne bacteria that settle in the lungs and cause long-term infection. Many people who are infected do not become ill themselves but can spread it.

The annual number of new TB cases in 18 worst hit countries in Africa has quadrupled since 1990 and continues to rise, fueled by a lethal mix of poverty, HIV/AIDS which weakens the immune system, and understaffed, crumbling health systems. Elsewhere in the world, WHO says, TB trends are either stable or in decline.

"We have frequently gone into denial when faced with unpleasant, unpalatable facts and now we are hearing from governments in Africa that they are not going into denial but that they are facing up to a horrendous situation forthwith," said Nobel Laureate Desmond Tutu, who spent 20 months in hospital as a teenager with TB and has now joined the campaign to raise awareness about its toll on Africa.

"We call on the international community which was so tremendous in its fight against another epidemic, apartheid, to show the same commitment to deal with TB and HIV/AIDS," the anti-apartheid veteran said in a telephone conference call from his home in Cape Town Friday.

Leading Killer of People Living with HIV/AIDS

There has been no new reliable test for the disease developed in a century and no new treatment for decades.

"Africa is the one region where TB is totally out of control," said Karin Weyer, a TB expert with South Africa's Medical Research Council, which forecasts that there will be 300,000 cases and 30,000 deaths from TB in South Africa this year -- a fatality rate of 10 percent compared to a fatality rate of 3-5 percent before the arrival of HIV/AIDS.

The Maputo declaration "is a good first step but good declarations need to be followed by action," Weyer said Friday.

Tuberculosis is the most common infection among -- and leading killer of -- people living with HIV/AIDS. Of the estimated 25 million Africans now living with HIV, about 8 million also harbor the bacillus that causes TB. Each year, 5 to 10 percent of these 8 million develop active TB, according to WHO figures.

In the late 1970s and early 1980s, Mozambique, Tanzania, and Malawi were among the first to apply what became the global TB control strategy, a program under which trained workers monitor patients to ensure drugs are taken properly.

The cost of the six-month course of drugs is just US$15 (€12). And yet, in the past 15 years, TB incidence rates have soared in the region -- by fourfold in Malawi and fivefold in Kenya.

"Despite commendable efforts by countries and partners to control tuberculosis, impact on incidence has not been significant and the epidemic has now reached unprecedented proportions," said WHO Africa director Dr. Luis Gomes Sambo. "Urgent and extraordinary actions must be taken."

"We take emergency action every time there is an outbreak of a disease like Abola in Africa," Helene Gayle, director of HIV/TB programs for the Bill and Melinda Gates Foundation, said about the hemorrhaging fever whose very name spreads fear because of the horrific death.

"And yet TB will kill more Africans today than Ebola over the past 30 years," she said.

Associated Press Writer Clare Nullis contributed to this report from Cape Town, South Africa.

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