Abstract

Purpose of review
Health and demographic surveillance systems (HDSS), in conjunction with HIV treatment cohorts, have
made important contributions to our understanding of the impact of HIV treatment and treatment-related
interventions in sub-Saharan Africa. The purpose of this review is to describe and discuss innovations in
data collection and data linkage that will create new opportunities to establish the impacts of HIV
treatment, as well as policies affecting the treatment cascade, on population health and economic and
social outcomes.
Recent findings
Novel approaches to routine collection of biomarkers, behavioural data, spatial data, social network
information, migration events and mobile phone records can significantly strengthen the potential of HDSS to
generate exposure and outcome data for causal analysis of HIV treatment impact and policies affecting the
HIV treatment cascade. Additionally, by linking HDSS data to health service administration, education and
welfare service records, researchers can substantially broaden opportunities to establish how HIV treatment
affects health and economic outcomes when delivered through public sector health systems and at scale.
Summary
As the HIV treatment scaleup in sub-Saharan Africa enters its second decade, it is becoming increasingly
important to understand the long-term causal impacts of large-scale HIV treatment and related policies on broader
population health outcomes, such as noncommunicable diseases, as well as on economic and social outcomes,
such as family welfare and children’s educational attainment. By collecting novel data and linking existing data
to public sector records, HDSS can create near-unique opportunities to contribute to this research agenda.