Actionable Guidelines for Promoting Equity, Diversity and Inclusion in Infectious Disease Modelling

Actionable Guidelines for Promoting Equity, Diversity and Inclusion in Infectious Disease Modelling Xiahui Li*1, Dongni Zhang*2, Hannah Clapham3, Louise Dyson4, T. Deirdre Hollingsworth5, Kathy Leung6,7,8,9, Denis Mollison10, Wirichada Panngum11, Ben Swallow1, Robin N. Thompson12, C´ecile Tran-Kiem13, Jack Woodruff14, and Shweta Bansal**15 1School of Mathematics and Statistics, University of St Andrews, St Andrews, UK 2Department of Health, Medicine and Caring Sciences, Link¨oping University, Link¨oping, Sweden 3Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 4The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, School of Life Sciences and Mathematics Institute, University of Warwick, Coventry, CV4 7AL, UK 5NDM Centre for Global Health Research, University of Oxford, UK 6WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China 7The Hong Kong Jockey Club Global Health Institute, Hong Kong SAR, China 8Laboratory of Data Discovery for Health (D²4H), Hong Kong Science Park, Hong Kong SAR, China 9The University of Hong Kong—Shenzhen Hospital, Shenzhen, China 10Mathematics and Computer Science, Heriot-Watt University, Scotland 11Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand 12Mathematical Institute, University of Oxford, Oxford, UK 13Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA 14School of Mathematical and Physical Sciences, University of Sheffield, Sheffield, UK 15Department of Biology, Georgetown University, Washington DC, USA *Co-first authors ** Corresponding author: [email protected] 1 Abstract Infectious disease modelling plays a critical role in understanding and addressing global health challenges. However, the field faces persistent barriers related to Equity, Diversity and Inclusion (EDI), including language and cultural biases, underrepresentation of certain groups and systemic inequities in access to resources and opportunities. This paper identifies key challenges and proposes actionable guidelines to foster inclusivity, collaboration and innovation in the field. Unlike generic EDI guidelines, we provide context-specific recommendations for three key settings in infectious disease research: team dynamics, conferences and virtual collaborations. We emphasise practical steps that can be taken such as diversifying conference organising committees, accommodating participants’ needs and integrating mentorship programmes. While recognising that EDI initiatives must be tailored to specific cultural and institutional settings, we highlight the importance of measurable progress through continuous reflection, assessment and adaptation. By embracing EDI principles, the field of infectious disease modelling can better harness the strengths of a diverse global community, leading to more equitable science, more representative models and improved health outcomes worldwide. Keywords: Equity, Diversity, Inclusion, Infectious Disease Modelling, Actionable Guidelines 2 1. Introduction In the rapidly evolving field of infectious disease modelling, where global collaboration and interdisciplinary efforts are paramount, the integration of Equity, Diversity and Inclusion (EDI) principles is crucial for shaping an inclusive and innovative scientific community and improving health outcomes globally. This is particularly important for populations that are disproportionately affected by infectious diseases, including those in lowand middle-income countries (LMICs) and communities with limited access to healthcare [35, 8, 12]. Unlike many fields, infectious disease modelling inherently requires integrating perspectives from epidemiologists, mathematicians, clinicians, social scientists and decision makers, a diversity that demands intentional inclusivity to bridge disciplinary divides and power imbalance. Despite growing recognition of the importance of EDI in recent years, substantial challenges remain, including language and cultural barriers, unequal representation and participation, and limited opportunities for individuals from underrepresented groups [13, 17, 27, 36, 14]. Language barriers pose a major obstacle for non-English-speaking researchers in scientific fields, including infectious disease modelling. Most scientific discourse and publications are communicated in English, limiting access for non-native speakers to access and engage with cutting-edge research. For example, Amano et al. [5] found that non-native English speakers, especially early career researchers, require more time to write scientific manuscripts in English and face a higher probability that their manuscripts are rejected by journals. In addition, systemic barriers related to gender and ethnicity also persist. Cori [11] highlighted the underrepresentation of women and ethnic minorities at senior levels in the field. At the Epidemics9 conference, women made up only 29.5% of presenters among professors and 5.8% of presenters came from Africa (compared to 14.4% of the global population [26]), illustrating substantial disparities. A recent study by Taube et al. [34] found that gender and ethnic disparities remain prevalent in authorship and citation practices. Between 2000 and 2019, men were lead authors on 61% of publications in the infectious disease dynamics field and senior authors on 67%. The same study also showed that women and authors of color are undercited by over 30%. Aakhus et al. [1] investigated authorship order among gender-discordant co–first authors and found that women were less likely than men to be listed first in publications in clinical and basic science journals. These biased authorship and citation patterns not only reflect systemic inequities but also reinforce structural disadvantages for underrepresented groups, even in highly interdisciplinary fields. Similarly, unequal access to funding opportunities and high-profile conferences creates a divide between researchers from lowand middle-income countries (LMICs) and those in high-income countries (HICs). Velin et al. [35] found that only on average 39% of attendees at global health conferences were from LMICs between 1997 and 2019, with 96% of these conferences held in MICs or HICs, limiting accessibility due to visa restrictions and financial barriers. Unconscious bias further undermines inclusivity by affecting panel discussions at conferences [7], research promotion [16] and the peer review process [31, 29]. This bias often skews recognition and opportunities, reinforcing inequities in the field. Additionally, a more sensitive and inclusive approach to communicating research findings is essential in a global field like infectious disease modelling. Regardless of the relationship between the researchers and the population groups being studied, it is essential to frame research 3 findings respectfully and avoid stereotyping or negative generalisations [22, 2]. For example, phrasing such as “Country X performed poorly in managing Disease Y” ignores the broader structural determinants of health, shifting blame onto populations. Similarly, reductive labels such as “people with X infection” risk defining individuals solely by their health condition, contrary to person-first language guidelines recommended by organisations such as the Centers for Disease Control and Prevention (CDC) [9] and the American Psychological Association (APA) [6]. These examples highlight the importance of thoughtful language choices that avoid reinforcing confrontational statements. While there has been progress in recognising the importance of EDI, much work remains to integrate these principles into infectious disease modelling. To address these challenges, we propose some actionable guidelines for implementing EDI in the field. The manuscript is organised as follows: Section 2 describes the collaborative process through which our guidelines were developed. Section 3 outlines recommendations for building an inclusive research culture and specific recommendations for team environments, conferences and workshops, and virtual collaborations. Section 4 discusses implications and future directions. The appendix provides posters that summarise our recommendations for each specific context, designed as practical tools for application. These posters (available at https://github.com/XiahuiLi-ab/edi-idd-posters) can be freely downloaded and modified: we encourage readers to use these posters and to adapt them as required in different contexts. 2. Process This manuscript emerged from discussions within an EDI working group formed during the 2024 Isaac Newton Institute programme on “Modelling and Inference for Pandemic Preparedness”. The programme brought together researchers from diverse disciplines, including epidemiology, mathematics, public health and social sciences. The working group was established to address the absence of formal EDI discussions at major infectious disease modelling conferences. Over four weeks of in-person and virtual meetings, working group members were asked to identify key challenges and propose solutions for promoting inclusivity in infectious disease modelling. These contributions were collated and organised into recommendations across three key settings: team environments, conferences and workshops, and virtual collaborations. While the list of recommendations is not intended to be exhaustive, these settings were selected because they directly influence who participates in modelling, whose perspectives shape models, and how equitable access to collaborations is facilitated. All working group members (including those not listed as co-authors) provided feedback on the synthesised recommendations before finalisation. While the programme included researchers from multiple disciplines and career stages, we acknowledge that the author group represents only a subset of the broader and more diverse working group. This work is considered as collective output that captures shared reflections from a larger community. Meanwhile, the working group itself also reflects limitations in geographic and demographic diversity that are typical of academic conferences in this field. We therefore view this work as a starting point and recognise that more diverse voices are needed in future work. 4 3. Actionable Guidelines Promoting EDI in infectious disease modelling demands deliberate and sustained efforts to support underrepresented groups, foster fairness and address both language and cultural barriers. General principles include creating equitable opportunities for leadership, speaking and participation while being mindful not to overburden individuals from these groups. Fairness should permeate all aspects of the modelling process, including attribution, authorship, and publication and funding review practices. Strategies such as double-blind peer review and recognition of diverse contributions are beneficial to promote fairness. Addressing language barriers requires clear communication, supportive writing practices and accessible technical resources, while cultural barriers can be mitigated by using inclusive language, respecting names and pronouns, and offering pronunciation aids. These principles serve as a foundation for EDI efforts and can be adapted to specific contexts, but their success relies on embedding them within a supportive research culture where the principles can be translated into meaningful action. A positive research culture is essential for the advancement of EDI, as it creates an environment in which people feel valued, respected and empowered to contribute fully. This culture promotes trust, collaboration and innovation by reducing systemic barriers that often limit the participation of underrepresented groups. Fostering this culture involves promoting inclusive interaction and networking through diverse roundtables, panel discussions and social events that respect cultural diversity (e.g., offering nonalcoholic options, inclusive food choices and spaces that accommodate different cultural or religious practices). Clear guidance for working groups and breakout sessions ensures that participants understand their objectives, processes and follow-up actions. Regular discussions on EDI topics during team meetings provide a platform for sharing experiences and fostering openness, while tailored career development guidance supports smooth transitions and personal growth, allowing all researchers to thrive irrespective of their background or career stage. Increasing awareness of EDI in the workplace and creating space to share experiences related to various aspects - such as gender bias, racism, antiLGBTQ+ bias, age discrimination, disability inclusion and caregiving responsibilities - are key to fostering a more inclusive research environment. Such discussions can serve as a foundation for capacity building and increased awareness of EDI. Although a positive research culture provides the overarching foundation, the practical application of EDI principles often depends on the specific context in which they are implemented. Within a team, fostering inclusivity requires deliberate efforts to build trust, distribute responsibilities equitably and ensure that all members have opportunities to contribute meaningfully. At conferences and workshops, EDI practices must address greater participation by creating accessible and welcoming environments for diverse participants. In increasingly virtual workspaces, unique strategies are needed to ensure inclusivity across geographic, technological and cultural boundaries. The following sections explore strategies for fostering EDI within these key contexts, providing actionable guidance tailored to each setting. Detailed suggestions are outlined in the posters in Appendix A for easy reference and dissemination. 3.1. Within a Team Infectious disease modelling is an interdisciplinary field that brings together expertise from mathematics, public health, biology and related disciplines. However, while disci5 plinary diversity is common, the field continues to face challenges in achieving diversity at the individual level, including gender, race and ethnicity, socioeconomic background, disability status, sexuality and country of origin. Evidence from the field, as well as academia more generally, shows that persistent inequalities in representation and career progression remain, particularly for women and ethnic minorities [21]. Improving EDI therefore requires intentional efforts to ensure that individuals from underrepresented groups have equitable opportunities to participate and thrive. Fostering inclusivity within a team requires cultivating an environment in which open communication and respect for diverse perspectives are prioritised. An inclusive team that values individual diversity benefits from a broader range of lived experiences, insights and problem-solving approaches. This diversity can be supported through initiatives such as offering paid internships and travel support, which help reduce financial barriers to participation, and by ensuring fair recognition in authorship, citations and peer review processes. Creating space for different voices in the discussion and accommodating various needs are key elements in promoting fairness within a team, while equitable participation strengthens collaboration and fosters trust among team members. Importantly, equitable participation also depends on addressing structural and procedural biases. Implementing transparent and inclusive hiring practices, establishing clear and objective criteria for promotion and recognition, and providing bias-awareness training for team members can help avoid discrimination and promote fairness in career progression [21, 23, 32]. Regularly reviewing recruitment and evaluation processes can further ensure that opportunities are accessible to all qualified individuals. To create a supportive work environment, it is essential to develop clear and accessible group policies and support skill development for all team members. For example, offering targeted training opportunities for underrepresented or early-career researchers and mentorship programmes can empower team members to build expertise and confidence. In particular, pairing underrepresented team members with mentors helps advance their professional growth. Emerging technologies such as large language models (LLMs) can enhance inclusive team environments by helping early-career researchers or those from under-resourced settings build skills and confidence in tasks such as coding, literature reviews and scientific writing. When used responsibly, LLMs can complement mentorship and reduce barriers to participation. Moreover, teams can also address bias and discrimination by providing bias awareness training, establishing clear reporting and feedback mechanisms, and implementing inclusive performance evaluation systems [4, 25]. Finally, recognising contributions fairly and implementing diverse reward systems help build a team culture where everyone feels valued and appreciated. Such reward systems should account for individual circumstances, such as accommodating those with caregiving responsibilities and recognising non-traditional contributions including data management, community outreach and mentoring. 3.2. Conferences and Workshops Given the highly interdisciplinary nature of infectious disease modelling and its role in informing urgent public health decisions, conferences and workshops serve as important venues for bringing together individuals with different expertise and fostering knowledge exchange across diverse fields. They can offer a powerful platform to advance EDI by providing accessible, inclusive and diverse environments. Our recommendations include 6 diversifying organising committees and speakers, offering hybrid participation options and reserving funds to support individuals who might otherwise be unable to attend - this may include childcare funding (or even childcare provision) or other tailored support for those with caring responsibilities. Providing translation services, whether by human interpreters or AI tools, could improve access and inclusion for non-native English speakers. Early sharing of essential information (i.e., location, accessibility or visa requirements) and clear codes of conduct that explicitly address bias, discrimination and harassment (such as providing clear definitions of unacceptable behaviour and outlining safe reporting mechanisms) further enhance inclusivity [15, 20]. Mentorship programmes and non alcohol-centred social events ensure broader participation and engagement, while accessible presentations (e.g., using readable fonts and sufficient colour contrast for those with visual sensitivity, and providing live captioning and screen-reader support) help ensure inclusion of participants with diverse accessibility needs [24]. In question-and-answer (Q&A) sessions, structured or anonymous question formats can reduce participation barriers. Addressing gender gaps in Q&A participation, that persist across both in-person and virtual settings [19], is a clear target for improvement. Clear roles and transparent processes in working groups promote fairness, and post-conference feedback and diversity evaluations guide continuous improvement. 3.3. Virtual Environments Virtual collaborations are increasingly central to infectious disease modelling, allowing geographically dispersed experts from multiple disciplines to share data rapidly, co-develop models and respond collectively to emerging outbreaks. The shift to remote environments offers both opportunities and challenges for promoting EDI. Improving accessibility in virtual settings begins with advanced distribution of materials to accommodate diverse needs, while recordings can ensure information remains accessible across time zones. Using a diverse range of communication methods, including asynchronous text-based platforms (such as Slack), supports inclusion by accommodating different communication preferences and the needs of those with caring or other responsibilities that may make real-time communication difficult at certain times. Recognising that reliable internet access is not universal, sharing meeting minutes or written summaries allows broader access to key discussions and decisions. Providing technical support and equitable access to tools and data promotes fair participation. Moreover, organising hybrid social activities can help build a connected and inclusive remote team culture, supporting team members’ sense of belonging. 4. Discussion and Future Directions EDI initiatives are vital for improving the field of infectious disease modelling. When the modelling community includes researchers from the regions being studied, practitioners with diverse technical experience and collaborators from a range of cultural backgrounds, the resulting models are more likely to capture complex transmission dynamics, generate locally feasible policy recommendations and ultimately contribute more successfully to the formulation of effective disease control measures. In this paper, we have analysed current barriers to EDI and proposed actionable guidance for fostering EDI in various settings, with a focus on team dynamics, conferences and virtual collaborations. If these 7 recommendations are implemented, we contend that infectious disease modelling would become a stronger and more inclusive discipline, providing ideal conditions for the development of innovative and equitable public health solutions. We acknowledge that these recommendations may not fully address the unique challenges faced by all underrepresented groups, particularly in diverse cultural and institutional contexts. The effectiveness of these practices may vary across settings, requiring adaptation to local norms, resources and priorities. Moreover, systemic change is often gradual, and measuring the impact of EDI initiatives remains a complex task, complicated by the lack of standardised metrics and the dynamic nature of the field. We also acknowledge that the authorship of this work reflects limited representation, weighted toward high-income countries. This imbalance also mirrors the inequities our paper aims to highlight. We hope that this work will encourage more inclusive and geographically diverse participation in future collaborations within the field. While our article focuses on fostering EDI within research environments, equity considerations can also shape the analyses undertaken by infectious disease modellers. Recent studies have demonstrated that incorporating differential exposure and structural inequities into models can influence both model design and interpretation [3, 37, 28, 30]. Promoting EDI is not a one-time effort but an ongoing journey that demands sustained commitment and continuous reflection [10]. This includes the development and refinement of metrics to track progress, as well as the collection and analysis of data on representation, participation and inclusion. These steps will promote equity-related decision-making in areas such as resource allocation, recruitment, the provision of leadership opportunities and the design of accessible events. It is essential that strategies are adapted in response to emerging challenges and insights [18]. Further research is needed to evaluate the effectiveness of EDI initiatives and to create context-specific solutions that address the unique needs of different regions and institutions [33]. Persistent disparities in representation and recognition are not solely the result of disciplinary practices, but are rooted in structural inequities affected by factors including colonialism, imperialism, wealth, racism and sexism, among others. These factors continue to influence the global research agenda, funding opportunities and access to educational and professional opportunities. While a full examination of these dynamics is beyond the scope of this paper, we recognise that meaningful progress toward providing opportunities for all individuals requires awareness of these factors and their potential effects. Overall, core strengths of the field of infectious disease modelling must include the diversity of its contributors and the inclusivity of its practices. While this article has focused on specific settings such as conferences, teams and virtual environments, embracing EDI is also essential in other areas, including recruitment processes and funding allocation. The implementation of EDI practices provides a tangible pathway to better science and improved global health outcomes. We view this work as a catalyst for ongoing conversation, and hope that it will promote continued reflection, discussion and collaboration throughout the infectious disease modelling community. Through deliberate action, continuous improvement and sustained commitment, we can shape a future in which every voice can contribute meaningfully to the advancement of the field, ultimately benefiting societies worldwide. 8 5. Acknowledgments The authors would like to thank the Isaac Newton Institute for Mathematical Sciences, Cambridge, for support and hospitality during the Modelling and Inference for Pandemic Preparedness (INI MIP) programme, where work on this paper was initiated. We thank Juliet Pulliam and other members of the INI MIP programme (beyond the authors of this article) for their contributions. This work was supported by EPSRC grant EP/Z000580/1. K.L. and T.D.H. would like to thank the Simons Foundation for supporting their visit to Cambridge. W.P. works for the Thailand-Major International Programme, funded by Wellcome [220211]. References [1] Erin Aakhus, Nandita Mitra, Ebbing Lautenbach, and Steven Joffe. 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