The incidence rates of tuberculosis (all forms) in Africa doubled between 1990 and 2007. During the same period, reported rates of new cases per 100,000 people across the African continent rose from 2 to 132, reflecting improved surveillance systems and increased incidence linked to the HIV epidemic. African countries have significantly stepped up their efforts to combat tuberculosis and HIV, aided by funding mechanisms such as the Global Fund to Fight AIDS, Tuberculosis and Malaria and by unprecedented support from bilateral and multilateral partners. Coverage of the tuberculosis control strategy recommended by the World Health Organization (known as the DOTS strategy) increased from 43% in 1995 to 94% in 2007. However, only one of the nine African countries ranked among the world’s 22 countries with high tuberculosis endemicity has achieved the targets of a 70% detection rate and an 85% treatment success rate. There is an urgent need to integrate HIV testing into tuberculosis diagnostic procedures, to expand treatment for HIV-tuberculosis coinfection to reduce mortality, and to control nosocomial transmission of tuberculosis. (R.A.)