The already pathetic health system in the region is taking a terrible knock as a double epidemic wave of TB and HIV rages unabated, reports say.
Local health systems are unable to contain the co-epidemic, the Forum for Collaborative HIV Research says.
The situation is made more urgent by increasing rates of drug-resistant tuberculosis (TB) in areas with a high prevalence of HIV.
Half of all new TB cases in sub-Saharan Africa are now HIV co-infected, forum director Veronica Miller said.
Sub-Saharan Africa is the term used to describe the area of the African continent which lies south of the Sahara desert. There are 42 countries located on the sub-Saharan African mainland and 6 island nations. South Africa, Somalia, Ethiopia and Rwanda are among the countries that fall in this belt.
While about 20% of the world's population are estimated to suffer from TB, most of them will not develop the disease.
However in Africa's slums, where people live crammed together in tin shacks, TB is rife, the Forum report notes.
Because HIV has destroyed the immune systems of at least a quarter of the population in some areas, far more people are not only developing TB but spreading it to otherwise healthy neighbours.
The BBC's Peter Greste in Cape Town says areas around the South African city are among the worst affected.
In one community in the western Cape, a child is 100 times more likely to contract TB than anyone living in the developed world.
But one Cape Town-based researcher, Dr Stephen Lawn, says existing tests often cannot spot TB before it is too late and health care systems cannot cope.
Without proper treatment, the Forum for Collaborative HIV Research notes despondently, 90% of people with HIV die within months of contracting TB.