Citation: Gerardin J, Penny MA (2025) How can modeling responsibly inform decision-making in malaria? PLoS Biol 23(1):
e3002991.
https://doi.org/10.1371/journal.pbio.3002991
Published: January 15, 2025
Copyright: © 2025 Gerardin, Penny. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: The author(s) received no specific funding for this work.
Competing interests: The authors have declared that no competing interests exist.
Mathematical models are sets of simplifying assumptions, based on current knowledge, about how the world works, followed to their logical (mathematical) conclusion. Different models make different sets of assumptions and are calibrated to different data sets. Models have been applied to problems in malaria for many years [1]. A century ago, models provided the theoretical basis for vector control, explaining why shortening the mosquito life span is one of the strongest methods for reducing transmission [2]. As our knowledge of the malaria system has grown, so has our ability to develop mechanistic transmission models—mathematical models that distill key disease dynamics and encode the processes of malaria infection and transmission into mathematical equations. These models are useful for simulation studies that explore processes for which there is no observed data and test possible scenarios.
Two decades ago, proponents argued that the role of models in evidence-informed decision-making for malaria should be to identify knowledge gaps and approximately compare alternative intervention strategies [3]. These remain the core strengths of mathematical models. However, since then, computational power has massively increased; malaria has received renewed focus at the global level and more funding; and malaria epidemiology and the intervention landscape have increased in complexity. The ambition for modeling has exploded, both in terms of what modelers are trying to accomplish and the expectations coming from decision-makers that models be capable of understanding and predicting ever more complex real-world effectiveness over time.
Models continue to be used to understand disease dynamics and their influencing factors, such as the evolution of resistance. However, models are now, implicitly or explicitly, also tasked with supporting decision-makers by providing quantitatively accurate predictions of lives saved or cases averted by certain interventions. During research and development (R&D) of novel malaria interventions, for example, transmission models are used to understand the potential impact of new tools before large-scale trials. Models are helping estimate the efficacy and duration requirements of new therapeutics [4], vaccines, and gene-drive mosquitoes [5]. Model predictions can also support decisions of where to target R&D resources or which delivery strategies to prioritize for deployment.
Model outputs are also increasingly used as additional evidence when decision-makers set national intervention strategies or set global policy. Unfortunately, it is often forgotten that models must extrapolate to these desired output metrics with limited data, especially on mortality. Furthermore, it is not always evident that end users understand whether a model is fit for purpose (Fig 1), nor that modelers always adequately communicate model limitations in their haste to be part of decision-making. Decision-makers seldom request proof of rigor, trusting that modelers have validated their models and tested their conclusions. Some modelers assume decision-makers are not interested in or cannot understand the models’ inner workings, and gloss over critical limitations in pursuit of maximal application of the models. Recent rising demand for modeling has led several modeling groups to apply models as black box algorithms, and thus they do not themselves fully understand the models they use. Despite over a century of malaria model development and application, these disconnects are leading to potential misuse of models in decision-making. As a worst-case outcome, potentially wrong health policies are put in place, and eventually modelers are blamed for the consequences of misuse, with models being scapegoated as decision-makers try to evade accountability. However, when used well, models have tremendous value to rigorously inform our thinking about the future.
Fig 1. Ensuring a model is fit for purpose in decision-making.
Any model should demonstrate that it is fit for purpose before it is used to inform decision-making. In malaria, key gaps persist that limit the ability of models to provide quantitatively accurate predictions of scenario outcomes. Solutions include the use of multiple models, continuous model improvement, expanded data collection, and transparency on model limitations.
At the national level, intervention policies are set by local decision-makers under the leadership of national malaria programs. Modeling can be used to predict the impact of combinations of possible interventions and to understand the impact of past interventions [6]. However, data gaps regarding each country’s malaria context, and the exclusion of social factors by the models [7], mean that model results must have substantial uncertainty, even if the core model captures the natural history of malaria well.
At the global level, policymakers and funders such as the World Health Organization (WHO) and the Global Fund to Fight AIDS, Tuberculosis, and Malaria use models to forecast trends, estimate needs, assess gaps, set realistic targets, and understand the cost-effectiveness of interventions [8]. Outputs of global models are not intended (nor appropriate) to be applied to individual countries, even if they are sometimes supplied at the country level. Global-level modeling cannot capture all the necessary contextual information of specific countries, especially if country data and country expertise to inform key assumptions, the feasibility of intervention combinations, and priority outcomes were absent during model building.
The gaps summarized in Fig 1, which are not unique to malaria, necessitate that model results cannot be viewed as single quantitative predictions of the future—neither for malaria nor for other diseases. Therefore, overly quantitative applications of model outputs, such as using models to drive optimization algorithms for intervention planning to obtain a given health outcome, are inappropriate. While model outputs can give a useful idea of whether an intervention would have a large or small impact, they are not accurate enough to select between intervention combinations unless the difference in impact is large and robust to uncertainty in contextual factors.
Despite data challenges, models that are well-informed by local expertise remain incredibly useful when comparing the relative impact of different potential interventions and qualitatively assessing different strategies. This approach, where candidate intervention scenarios are generated through review and analysis of local data, and modeling is then used to estimate their relative impact, has been successfully used in several countries to prioritize intervention strategies [9].
Even when models are calibrated to the same reference data with comparable goodness of fit, they might not behave similarly in out-of-sample contexts due to differences in structural assumptions [10]. In other applications, such as forecasts of climate change and COVID-19 trends, decision-makers consider multiple models as an ensemble or with all results presented. Using multiple models from many teams provides more robust predictions and representation across multiple reasonable sets of assumptions, while still preserving the different uncertainties within and across models [11]. Unfortunately, multiple models are not sufficiently used when informing malaria decision-making (this includes work done by the authors). When making the investment case for malaria, the Global Fund has often relied on one mathematical model. Although not always achieved [12], WHO’s best practice is to request multiple models to provide evidence for impact and cost-effectiveness estimates [13,14]. GAVI, the Vaccine Alliance, uses three malaria models to assess the potential impact of various malaria vaccine rollout scenarios. At the national level, we are unaware if multiple models have ever been used during intervention planning.
Outside of a few consensus modeling exercises, it is not known whether different malaria models yield similar predictions of the impact of interventions. Systematically aligning and testing complex models requires substantial time commitments from experts in each model. However, continuing to avoid systematic model comparison does a disservice to the end users of model outputs, who risk receiving different answers to their questions depending on their choice of model.
Building trust and encouraging the uptake of useful modeling requires everyone to be honest about the limitations of each model. Otherwise, the overapplication (or worse, intentional or unintentional misuse) of models risks discrediting the entire field. Modelers have an obligation not to oversell and to be part of the conversation rather than advertise that they have the “quantitative” solution. Equally, those considering modeling evidence should ensure they understand the limitations, do not cherry-pick results to advocate for a particular conclusion, are willing to pressure-test results, and support improving models. We must all work together to ensure ensemble modeling becomes a more frequent reality and to continuously develop and improve models to push the boundaries of what is possible.
No doubt the modeling field can and should change tremendously over the next 10 years. As new technologies and high-quality data become available, the scope of appropriate applications for modeling will expand. For today, we should be ethical and rigorous in acknowledging what is ready for deployment in decision-making and what is still in development. Models are and have been useful in our fight to defeat malaria—let’s collectively ensure they remain so.
ADVERTISEMENT:
Hello, para pencinta slots pernahkah mendengar semboyan “raja slot? jika belum, bersiaplah jatuh hati sama konsep ini. slot demo merupakan mesin slots yang selalu memberi kemenangan. Yup, slot-slot ini bisa dibilang sebagai jagoannya buat membawa come back cuan. any way, cemana sih
tekniknya jumpain slot demo yang tepat? Tenang Bro and Sis, kita beri santai saja di sini
Games terbaik waktu ini satu-satunya berada Indonesia yaitu pasti memberikan ROI terbaik
Daftarkanlah dengan di :
Informasi mengenai KING SLOT, Segera Daftar Bersama king selot terbaik dan terpercaya no satu di Indonesia. Boleh mendaftar melalui sini king slot serta memberikan hasil kembali yang paling tinggi saat sekarang ini hanyalah KING SLOT atau Raja slot paling gacor, gilak dan gaco saat sekarang di Indonesia melalui program return tinggi di kingselot serta pg king slot
slot demo gacor
slot demo gacor permainan paling top dan garansi imbal balik hasil besar bersama kdwapp.com
akun demo slot gacor
akun demo slot gacor permainan paling top dan garansi imbal balik hasil besar bersama kdwapp.com
akun slot demo gacor
akun slot demo gacor permainan paling top dan garansi imbal balik hasil besar bersama kdwapp.com
akun demo slot pragmatic
akun demo slot pragmatic permainan paling top dan garansi imbal balik hasil besar bersama kdwapp.com
akun slot demo pragmatic
akun slot demo pragmatic permainan paling top dan garansi imbal balik hasil besar bersama kdwapp.com
akun slot demo
akun slot demo permainan paling top dan garansi imbal balik hasil besar bersama kdwapp.com
akun demo slot
akun demo slot permainan paling top dan garansi imbal balik hasil besar bersama kdwapp.com
slot demo gacor
slot demo gacor permainan paling top dan garansi imbal balik hasil besar bersama jebswagstore.com
akun demo slot gacor
akun demo slot gacor permainan paling top dan garansi imbal balik hasil besar bersama jebswagstore.com
akun slot demo gacor
akun slot demo gacor permainan paling top dan garansi imbal balik hasil besar bersama jebswagstore.com
akun demo slot pragmatic
akun demo slot pragmatic permainan paling top dan garansi imbal balik hasil besar bersama jebswagstore.com
akun slot demo pragmatic
akun slot demo pragmatic permainan paling top dan garansi imbal balik hasil besar bersama jebswagstore.com
akun slot demo
akun slot demo permainan paling top dan garansi imbal balik hasil besar bersama jebswagstore.com
akun demo slot
akun demo slot permainan paling top dan garansi imbal balik hasil besar bersama jebswagstore.com
slot demo gacor
slot demo gacor permainan paling top dan garansi imbal balik hasil besar bersama demoslotgacor.pro
akun demo slot gacor
akun demo slot gacor permainan paling top dan garansi imbal balik hasil besar bersama demoslotgacor.pro
akun slot demo gacor
akun slot demo gacor permainan paling top dan garansi imbal balik hasil besar bersama demoslotgacor.pro
akun demo slot pragmatic
akun demo slot pragmatic permainan paling top dan garansi imbal balik hasil besar bersama demoslotgacor.pro
akun slot demo pragmatic
akun slot demo pragmatic permainan paling top dan garansi imbal balik hasil besar bersama demoslotgacor.pro
akun slot demo
akun slot demo permainan paling top dan garansi imbal balik hasil besar bersama demoslotgacor.pro
akun demo slot
akun demo slot permainan paling top dan garansi imbal balik hasil besar bersama demoslotgacor.pro
slot demo gacor
slot demo gacor permainan paling top dan garansi imbal balik hasil besar bersama situsslotterbaru.net
akun demo slot gacor
akun demo slot gacor permainan paling top dan garansi imbal balik hasil besar bersama situsslotterbaru.net
akun slot demo gacor
akun slot demo gacor permainan paling top dan garansi imbal balik hasil besar bersama situsslotterbaru.net
akun demo slot pragmatic
akun demo slot pragmatic permainan paling top dan garansi imbal balik hasil besar bersama situsslotterbaru.net
akun slot demo pragmatic
akun slot demo pragmatic permainan paling top dan garansi imbal balik hasil besar bersama situsslotterbaru.net
akun slot demo
akun slot demo permainan paling top dan garansi imbal balik hasil besar bersama situsslotterbaru.net
akun demo slot
akun demo slot permainan paling top dan garansi imbal balik hasil besar bersama situsslotterbaru.net
situs slot terbaru
situs slot terbaru permainan paling top dan garansi imbal balik hasil besar bersama situsslotterbaru.net
slot terbaru
slot terbaru permainan paling top dan garansi imbal balik hasil besar bersama situsslotterbaru.net
suara88 permainan paling top dan garansi imbal balik hasil besar bersama suara88.biz
sumo7777 permainan paling top dan garansi imbal balik hasil besar bersama sumo7777.com
supermoney888 permainan paling top dan garansi imbal balik hasil besar bersama supermoney888.biz
teratai88 permainan paling top dan garansi imbal balik hasil besar bersama teratai88.biz
thor88 permainan paling top dan garansi imbal balik hasil besar bersama thor88.biz
togelhk88 permainan paling top dan garansi imbal balik hasil besar bersama togelhk88.net
topjitu88 permainan paling top dan garansi imbal balik hasil besar bersama topjitu88.net
totosloto88 permainan paling top dan garansi imbal balik hasil besar bersama totosloto88.com
trisula888 permainan paling top dan garansi imbal balik hasil besar bersama trisula888.biz
udangbet88 permainan paling top dan garansi imbal balik hasil besar bersama udangbet88.net
via88 permainan paling top dan garansi imbal balik hasil besar bersama via88.biz
virusjp88 permainan paling top dan garansi imbal balik hasil besar bersama virusjp88.net
warga888 permainan paling top dan garansi imbal balik hasil besar bersama warga888.biz
waw88 permainan paling top dan garansi imbal balik hasil besar bersama waw88.biz
winjitu88 permainan paling top dan garansi imbal balik hasil besar bersama winjitu88.net
wisdom88 permainan paling top dan garansi imbal balik hasil besar bersama wisdom88.biz
wnitogel88 permainan paling top dan garansi imbal balik hasil besar bersama wnitogel88.com
yoyo888 permainan paling top dan garansi imbal balik hasil besar bersama yoyo888.biz
validtoto88 permainan paling top dan garansi imbal balik hasil besar bersama validtoto88.com
sule999 permainan paling top dan garansi imbal balik hasil besar bersama sule999.com
sule88 permainan paling top dan garansi imbal balik hasil besar bersama sule88.org
ss888bet permainan paling top dan garansi imbal balik hasil besar bersama ss888bet.com
sia77 permainan paling top dan garansi imbal balik hasil besar bersama sia77.info
seluang88 permainan paling top dan garansi imbal balik hasil besar bersama seluang88.com
satu88 permainan paling top dan garansi imbal balik hasil besar bersama satu88.biz
satu777 permainan paling top dan garansi imbal balik hasil besar bersama satu777.asia
rp88 permainan paling top dan garansi imbal balik hasil besar bersama rp88.biz
rp88 permainan paling top dan garansi imbal balik hasil besar bersama rp88.asia
rp88 permainan paling top dan garansi imbal balik hasil besar bersama rp77.live
qiuqiu88 permainan paling top dan garansi imbal balik hasil besar bersama qiuqiu88.biz
pt88 permainan paling top dan garansi imbal balik hasil besar bersama pt88.org
pt77 permainan paling top dan garansi imbal balik hasil besar bersama pt77.info
produk88 permainan paling top dan garansi imbal balik hasil besar bersama produk88.asia
mt88 permainan paling top dan garansi imbal balik hasil besar bersama mt88.org
mt77 permainan paling top dan garansi imbal balik hasil besar bersama mt77.biz
menang66 permainan paling top dan garansi imbal balik hasil besar bersama menang66.biz
latobet888 permainan paling top dan garansi imbal balik hasil besar bersama latobet888.org
kedai96 permainan paling top dan garansi imbal balik hasil besar bersama kedai96.org
kedai188 permainan paling top dan garansi imbal balik hasil besar bersama kedai188.biz
ids88 permainan paling top dan garansi imbal balik hasil besar bersama ids88.biz
hp88 permainan paling top dan garansi imbal balik hasil besar bersama hp88.org
hp77 permainan paling top dan garansi imbal balik hasil besar bersama hp77.org
gm88 permainan paling top dan garansi imbal balik hasil besar bersama gm88.asia
gm77 permainan paling top dan garansi imbal balik hasil besar bersama gm77.net
final888 permainan paling top dan garansi imbal balik hasil besar bersama final888.org
duit88 permainan paling top dan garansi imbal balik hasil besar bersama duit88.asia
duit168 permainan paling top dan garansi imbal balik hasil besar bersama duit168.biz
divisi88 permainan paling top dan garansi imbal balik hasil besar bersama divisi88.org
dewi500 permainan paling top dan garansi imbal balik hasil besar bersama dewi500.biz
devil88 permainan paling top dan garansi imbal balik hasil besar bersama devil88.info
cuputoto88 permainan paling top dan garansi imbal balik hasil besar bersama cuputoto88.com
cukongbet88 permainan paling top dan garansi imbal balik hasil besar bersama cukongbet88.asia
bom888 permainan paling top dan garansi imbal balik hasil besar bersama bom888.biz
bintaro888 permainan paling top dan garansi imbal balik hasil besar bersama bintaro888.info
askasino88 permainan paling top dan garansi imbal balik hasil besar bersama askasino88.org
999aset permainan paling top dan garansi imbal balik hasil besar bersama 999aset.com
afb77 permainan paling top dan garansi imbal balik hasil besar bersama afb77.biz
aset99 permainan paling top dan garansi imbal balik hasil besar bersama aset99.biz
bendera77 permainan paling top dan garansi imbal balik hasil besar bersama bendera77.biz
bendera888 permainan paling top dan garansi imbal balik hasil besar bersama bendera888.com
coco88 permainan paling top dan garansi imbal balik hasil besar bersama coco88.org
cuma77 permainan paling top dan garansi imbal balik hasil besar bersama cuma77.biz
cuma88 permainan paling top dan garansi imbal balik hasil besar bersama cuma88.org
dwv88 permainan paling top dan garansi imbal balik hasil besar bersama dwv88.org
fafajp88 permainan paling top dan garansi imbal balik hasil besar bersama fafajp88.com
gemar88 permainan paling top dan garansi imbal balik hasil besar bersama gemar88.biz
gocap88 permainan paling top dan garansi imbal balik hasil besar bersama gocap88.info
gocaptoto permainan paling top dan garansi imbal balik hasil besar bersama gocaptoto.asia
hakabet88 permainan paling top dan garansi imbal balik hasil besar bersama hakabet88.com
hwtoto88 permainan paling top dan garansi imbal balik hasil besar bersama hwtoto88.org
ina77 permainan paling top dan garansi imbal balik hasil besar bersama ina77.biz
ina88 permainan paling top dan garansi imbal balik hasil besar bersama ina88.info
jingga8888 permainan paling top dan garansi imbal balik hasil besar bersama jingga8888.com
juragan777 permainan paling top dan garansi imbal balik hasil besar bersama juragan777.asia
kastil77 permainan paling top dan garansi imbal balik hasil besar bersama kastil77.info
kebo888 permainan paling top dan garansi imbal balik hasil besar bersama kebo888.biz
kkwin77 permainan paling top dan garansi imbal balik hasil besar bersama kkwin77.com
kokoslot88 permainan paling top dan garansi imbal balik hasil besar bersama kokoslot88.asia
luckydf88 permainan paling top dan garansi imbal balik hasil besar bersama luckydf88.org
microstar888 permainan paling top dan garansi imbal balik hasil besar bersama microstar888.biz
monperatoto88 permainan paling top dan garansi imbal balik hasil besar bersama monperatoto88.com
mpo1122 permainan paling top dan garansi imbal balik hasil besar bersama mpo1122.biz
mpo122 permainan paling top dan garansi imbal balik hasil besar bersama mpo122.biz
mpopelangi88 permainan paling top dan garansi imbal balik hasil besar bersama mpopelangi88.com
pamanslot88 permainan paling top dan garansi imbal balik hasil besar bersama pamanslot88.biz
panel88 permainan paling top dan garansi imbal balik hasil besar bersama panel88.org
paragon77 permainan paling top dan garansi imbal balik hasil besar bersama paragon77.biz
paragon888 permainan paling top dan garansi imbal balik hasil besar bersama paragon888.info
pion77 permainan paling top dan garansi imbal balik hasil besar bersama pion77.biz
prada88 permainan paling top dan garansi imbal balik hasil besar bersama prada88.asia
prada888 permainan paling top dan garansi imbal balik hasil besar bersama prada888.com
qqslot88slot permainan paling top dan garansi imbal balik hasil besar bersama qqslot88slot.com
rejekibet88 permainan paling top dan garansi imbal balik hasil besar bersama rejekibet88.com
rezekibet88 permainan paling top dan garansi imbal balik hasil besar bersama rezekibet88.org
sensa77 permainan paling top dan garansi imbal balik hasil besar bersama sensa77.biz
sensa888 permainan paling top dan garansi imbal balik hasil besar bersama sensa888.biz
singajp88 permainan paling top dan garansi imbal balik hasil besar bersama singajp88.com
sr77 permainan paling top dan garansi imbal balik hasil besar bersama sr77.org
sr88 permainan paling top dan garansi imbal balik hasil besar bersama sr88.org
surya77 permainan paling top dan garansi imbal balik hasil besar bersama surya77.biz
surya88 permainan paling top dan garansi imbal balik hasil besar bersama surya88.asia
tajir77 permainan paling top dan garansi imbal balik hasil besar bersama tajir77.info
tajir88 permainan paling top dan garansi imbal balik hasil besar bersama tajir88.biz
toto122 permainan paling top dan garansi imbal balik hasil besar bersama toto122.com
toto123 permainan paling top dan garansi imbal balik hasil besar bersama toto123.biz
uangvip88 permainan paling top dan garansi imbal balik hasil besar bersama uangvip88.com
wajik77 permainan paling top dan garansi imbal balik hasil besar bersama wajik77.asia
777neko permainan paling top dan garansi imbal balik hasil besar bersama 777neko.org
88judi permainan paling top dan garansi imbal balik hasil besar bersama 88judi.net
99judi permainan paling top dan garansi imbal balik hasil besar bersama 99judi.org
abcslot88 permainan paling top dan garansi imbal balik hasil besar bersama abcslot88.asia