Data-Informed Decision-Making to End HIV and TB

Overview

CDC is the lead technical agency implementing the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). CDC's world-renowned experts use many sources of data to understand the nuances of these rapidly evolving diseases. These data help inform strategies for global HIV and TB related programs as well as country-specific programs and efforts. By centering data in planning and implementation, CDC ensures that policies, recommendations and decisions are evidence-based, efficient, and impact-oriented.

Routine monitoring prevents new infections

CDC works closely with ministries of health to establish and improve disease surveillance systems that measure existing and new HIV and TB infections. Data from these surveillance systems are analyzed to:

• Identify where the burden or risk of HIV and TB infections are higher.
• Identify which populations or communities are at higher risk.
• Understand factors that impact the spread of these diseases.

These analyses also help identify patterns of where infections occur and critical junctures where public health programs can help end or curb the spread of these diseases. Data are the basis and guide rails for evidence-based programs and policies that protect the public’s health and safety. CDC's routine data collection and analytic efforts play a key role in averting new infections. In addition to saving lives, this reduces the economic toll of HIV and TB-related illnesses and deaths.

Population-based surveys reveal progress and gaps

CDC works with partners to implement Population-based HIV Impact Assessments, commonly referred to as “PHIAs.” These HIV-focused household surveys are the international standard for measuring the state of the HIV epidemic among the general population.

Since 2015, PHIAs have been helping to:

• Understand the progress of HIV programs and identify remaining gaps.
• Help inform evidence-based approaches to achieve HIV epidemic control targets in partner countries.
• Measure HIV incidence, prevalence, treatment, viral load suppression, and HIV-associated behavioral risk factors.
• Identify where resources need to be focused for the greatest impact.

CDC is working with governmental, academic, and civil society partners to use data from these national surveys. This work helps improve the efficiency and effectiveness of programs designed to reach national and global HIV epidemic control goals. Data from CDC-supported PHIAs show that several countries have already achieved or surpassed global HIV epidemic control targets. To reach and maintain epidemic control, CDC and partners use PHIA data to help find persons living with previously undiagnosed HIV infections, link them to life-saving treatment, and achieve viral load suppression.

Understanding HIV burden and needs of people at higher risk

CDC supports bio-behavioral surveys (BBS) that provide estimates of HIV burden and risk factors among populations at higher risk for HIV infection. These populations include sex workers, men who have sex with men, transgender persons, and persons who inject drugs.

BBS surveys help partner countries understand the needs of people at higher risk. Data describing the number of people at higher risk and HIV service usage helps countries make informed decisions for planning and resources.

CDC experts provide technical assistance to countries conducting these surveys and then work with partners to apply the insights gained. The results help country partners make data-driven, real-time adjustments in national, regional and local HIV programming. CDC efforts are increasing efficiencies and improving health outcomes for people at higher risk.

Economic analysis: value, accountability, and efficiency

CDC economists analyze financial and economic data to enhance HIV and TB programs in PEPFAR supported countries and strengthen impact. CDC works with these countries and partners to assess the costs and impacts of HIV and TB programs. From these analyses, CDC helps to identify areas that could be more efficient - saving more lives while reducing cost. CDC's economics in collaboration with partners identify creative solutions to drive efficient, accountable, and sustainable programs.

Building sustainable data systems

HIV and TB programs rely on data to improve prevention and treatment services. Effective data collection systems require sustained investments, routine maintenance, well-trained staff, and constant evaluation and improvements.

CDC also plays a critical role in ensuring that data collection systems can be sustained by partner governments by providing technical assistance on integrating them into national public health systems. Building sustainable and responsive systems advances efforts in countries where we work as they begin to develop and implement roadmaps to take full ownership of their national HIV programs.

CDC-supported information and laboratory systems are critical not just for HIV and TB programs, but also for public health preparedness. Strong data collection systems are an essential part of public health infrastructure that can be rapidly repurposed or deployed to respond to emerging health threats.

Resources