Predictions for South Africa from our transmission model if universal access to treatment is achieved or a universal T&T (with annual testing) strategy is implemented.

Dynamics of acquired and transmitted drug resistance are included in these simulations. To generate this figure we assumed a treatment-induced reduction in infectivity of 85%, acquired drug resistance develops in treated individuals at a rate of 3% per year [10] and drug-resistant strains are 50% as transmissible as wild-type strains. Panel (A) shows annual incidence over time. The blue curve shows wild-type incidence if the T&T strategy is implemented; black curve shows wild-type incidence if universal access to treatment is achieved. The red dashed curve shows the maximum incidence of transmitted drug resistance if either universal access is achieved or the T&T strategy is implemented. Panel (B) shows the number of infections prevented over time for the T&T strategy (blue curve) and if universal access to treatment (black curve) is achieved. Panel (C) shows the number of individuals in need of treatment over time. Blue and red curves represent the T&T strategy; the blue curve shows the number of individuals in need of first-line regimens, the solid red curve shows the number in need of second-line regimens. Black and orange curves represent achieving universal access to treatment; the black curve shows the number in need of first-line regimens, the orange curve shows the number in need of second-line regimens.