Best Practices for Promoting Equity, Diversity, and Inclusion in Infectious Disease Modelling

Best Practices 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 best practices to foster inclusivity, collaboration, and innovation in the field. Our recommendations cover diverse contexts, including conferences, team dynamics, and virtual collaborations, and emphasize practical steps such as diversifying organizing committees, accommodating participant needs, and integrating mentorship programs. While recognizing 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, 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, Best Practices 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, particularly for populations most affected by infectious diseases. 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 EDI in recent years, substantial challenges remain, including language and cultural barriers, unequal representation and participation, and limited opportunities for underrepresented groups [6, 9, 13, 19, 7]. 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. [2] found that non-native English speakers, especially early career researchers, require more time to write a paper in English and face higher rejection probabilities due to English writing. In addition, systemic barriers related to gender and ethnicity also persist. Cori [5] highlights 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 [12]), illustrating substantial disparities. A recent study by Taube et al. [17] 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 the byline of articles published 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. [18] found that only on average 39% of attendees at global health conferences were from LMICs between 1997 and 2019, with 96% of these conferences were held in MICs or HICs, limiting accessibility due to visa restrictions and financial barriers. Unconscious bias further undermines inclusivity by shaping the panel discussions [3], research promotion [8] and peer review process [15, 14]. 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. Researchers may belong to the populations or regions being studied, making it essential to frame research findings respectfully and avoid stereotyping or negative generalizations [11]. For example, phrasing such as “Country X performed poorly in managing Disease Y” ignore the broader structural determinants of health, shifting blame onto populations. Similarly, reductive labels such as “people with X infection” 3 risk defining individuals solely by their health condition. These examples highlight the importance of thoughtful language choices that avoid reinforcing confrontational statements. While there has been progress in recognizing the importance of EDI, much work remains to integrate these principles systematically into infectious disease modelling. To address these challenges, we propose a structured framework with actionable guidance for implementing EDI best practices in the field. This manuscript reflects discussion from the 2024 Isaac Newton Institute programme on Modelling and Inference for Pandemic Preparedness, which attended by researchers from a wide range of background, such as epidemiology, mathematics, public health, and social sciences. Unlike generic EDI guidelines, we focus on solutions for three key settings: team environments, conferences and workshops, and virtual collaborations, as they are foundational to the daily practice of modelling. These settings were selected because they directly influence who participates in modelling, whose perspectives shape models, and how equitable access to collaborations is facilitated. Section 2 outlines recommendations for building an inclusive research culture and specific best practices for team environments, conferences (and workshops) and virtual collaborations. Section 3 concludes with discussion recapitulating the key points. The appendix provides example posters that summarize our recommendations for each specific context, serving as practical tools for application. These posters (available in https://github.com/XiahuiLi-ab/edi-idd-posters) can be freely downloaded and modified to suit various context needs. 2. Best Practices 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, with strategies such as double-blind peer review and recognition of diverse contributions. 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 culturally reflective social events. 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 members 4 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, age discrimination, disability inclusion and caregiving responsibilities - across different culture are key to fostering a more inclusive research environment. These efforts are particularly important in LMICs settings, where EDI may be a relatively new concept and 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 best practices 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. 2.1. Within a Team Infectious disease modelling is an interdisciplinary field, requiring close collaboration between individuals with expertise in mathematics, public health, biology, and related fields. Fostering inclusivity within a team requires cultivating an environment in which open communication and respect for diverse perspectives are prioritized. An inclusive team benefits from the varied insights of members with diverse backgrounds and experiences. This diversity can be enhanced through initiatives such as offering paid internships, travel support, which reduce financial barriers to participation, and by ensuring fair recognition in 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. In order to create a supportive work environment, it is essential to develop clear and accessible group policies and support skill development. For example, offering targeted training opportunities and mentorship programs 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. Finally, recognizing contributions fairly and implementing diverse reward systems helps build a team culture where everyone feels valued and appreciated. 2.2. Conference/Workshop 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 expertise and foster knowledge exchange across diverse 5 fields. They offer a powerful platform to advance EDI by fostering accessible, inclusive, and diverse environments. Best practices include diversifying organizing 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 other tailored support for those with caring responsibilities. Providing translation services, whether by human interpreters or AI tools, can improve access and inclusion for non-English speakers. Early sharing of essential information (i.e., location, accessibility, visa requirements) and clear codes of conduct further enhance inclusivity. Mentorship programs and non alcohol-centred social events ensure broader participation and engagement, while accessible presentations and facilitated Q&A sessions create opportunities for diverse voices to be heard. Clear roles and transparent processes in working groups promote fairness, and post-conference feedback and diversity evaluations guide continuous improvement. Detailed suggestions for implementing these practices are available through dedicated posters. 2.3. Virtual Environment Virtual collaborations are increasingly central to infectious disease modelling, allowing geographically dispersed experts from multiple disciplines to rapidly share data, 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 advance distribution of materials to accommodate diverse needs, while recordings can ensure information remains accessible across time zones. Using diverse communication methods including asynchronous and text-based platforms such as Slack or Teams supports inclusion by accommodating different communication preferences and the needs of those with caring or other responsibilities that make real-time communication difficult. Recognizing 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, organizing hybrid social activities helps build a connected and inclusive remote team culture, by supporting team member’s sense of belonging. 3. Conclusion EDI initiatives are vital for advancing infectious disease modelling. When the modeling community includes researchers from endemic regions, practitioners with diverse technical experience, and collaborators with diverse cultural backgrounds, the resulting models are more likely to capture complex transmission dynamics, generate feasible policy recommendations, and ultimately contribute to more effective infectious disease prevention and control. This paper analyzes current barriers to EDI and proposes a systematic framework with actionable guidance for fostering EDI across various settings, including team dynamics, conferences, and virtual collaborations. By implementing these recommendations, we aim to build a stronger, more inclusive community that drives innovative and equitable public health solutions. While our recommendations strive to be comprehensive, we acknowledge that they may not fully address the unique challenges faced by all underrepresented groups, particularly in diverse cultural and institutional contexts. The effectiveness of these practices 6 may vary across settings, requiring adaptation to local norms, resources, and priorities. Moreover, systemic change is inherently gradual, and measuring the impact of EDI initiatives remains a complex task, complicated by the lack of standardized metrics and the dynamic nature of the field. Promoting EDI is not a one-time effort but an ongoing journey that demands sustained commitment and continuous reflection [4]. This includes developing metrics to track progress, collecting data to guide decision-making, and maintaining a readiness to adapt strategies in response to emerging challenges and insights [10]. 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 [16]. In conclusion, the strength of infectious disease modelling lies in the diversity of its contributors and the inclusivity of its practices. While this work has focused on specific settings such as conferences, teams, and virtual environments, EDI are equally essential in other areas, including recruitment processes and funding allocation. Embracing EDI is a tangible pathway to better science and improved global health outcomes. Through deliberate action, continuous improvement, and sustained commitment, we can shape a future where every voice contributes meaningfully to the advancement of the field, ultimately benefiting societies worldwide. 4. Acknowledgments The author(s) 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 the INI MIP Equity, Diversity, and Inclusion Working Group 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. is working for the Thailand - Major International Programme, funded by Wellcome Trust [220211]. References [1] Erin Aakhus, Nandita Mitra, Ebbing Lautenbach, and Steven Joffe. Gender and byline placement of co-first authors in clinical and basic science journals with high impact factors. JAMA, 319(6):610–611, 2018. [2] Tatsuya Amano, Valeria Ram´ırez-Casta˜neda, Violeta Berdejo-Espinola, Israel Borokini, Shawan Chowdhury, Marina Golivets, Juan David Gonz´alez-Trujillo, Flavia Monta˜no-Centellas, Kumar Paudel, Rachel Louise White, et al. The manifold costs of being a non-native English speaker in science. PLoS Biology, 21(7):e3002184, 2023. [3] Kethaki Prathivadi Bhayankaram and Nuthana Prathivadi Bhayankaram. Conference panels: do they reflect the diversity of the NHS workforce? BMJ Leader, 6(1), 2022. [4] Molly Carnes, Patricia G Devine, Carol Isaac, Linda Baier Manwell, Cecelia E Ford, Angela Byars-Winston, Eve Fine, and Jennifer Sheridan. Promoting institutional 7 change through bias literacy. Journal of Diversity in Higher Education, 5(2):63, 2012. [5] Anne Cori. SIR. . . or MADAM? the impact of privilege on careers in epidemic modelling. Epidemics, page 100769, 2024. [6] Omar Dewidar, Nour Elmestekawy, and Vivian Welch. Improving equity, diversity, and inclusion in academia. Research Integrity and Peer Review, 7(1):4, 2022. [7] Michael El Boghdady. Equality and diversity in research: building an inclusive future. BMC Research Notes, 18(1):14, January 2025. [8] Oliver J Fisher, Debra Fearnshaw, Nicholas J Watson, Peter Green, Fiona Charnley, Duncan McFarlane, and Sarah Sharples. Promoting equality, diversity and inclusion in research and funding: reflections from a digital manufacturing research network. Research Integrity and Peer Review, 9(1):5, 2024. [9] Angela J Hattery, Earl Smith, Shannon Magnuson, Allison Monterrosa, Katherine Kafonek, Cameron Shaw, Rochelle Davidson Mhonde, and L Cait Kanewske. Diversity, equity, and inclusion in research teams: The good, the bad, and the ugly. Race and Justice, 12(3):505–530, 2022. [10] Vivian Hunt, Dennis Layton, Sara Prince, et al. Diversity matters. McKinsey & Company, 1(1):15–29, 2015. [11] Themrise Khan, Seye Abimbola, Catherine Kyobutungi, and Madhukar Pai. How we classify countries and people—and why it matters. BMJ Global Health, 7(6):e009704, 2022. [12] World Health Organization. Atlas of African Health Statistics 2022, 2022. [13] Lynne R Prince and Sheila E Francis. Barriers to equality, diversity and inclusion in research and academia stubbornly persist. so, what are we doing about it? Disease Models & Mechanisms, 16(7):dmm050048, 2023. [14] Alejandra Recio-Saucedo, Ksenia Crane, Katie Meadmore, Kathryn Fackrell, Hazel Church, Simon Fraser, and Amanda Blatch-Jones. What works for peer review and decision-making in research funding: a realist synthesis. Research Integrity and Peer Review, 7(1):2, 2022. [15] Sayaka Sato, Pascal Mark Gygax, Julian Randall, and Marianne Schmid Mast. The leaky pipeline in research grant peer review and funding decisions: challenges and future directions. Higher Education, 82(1):145–162, 2021. [16] Abigail J Stewart. An Inclusive Academy: Achieving Diversity and Excellence. The MIT Press, 2018. [17] Juliana C Taube, Alexes Merritt, and Shweta Bansal. Twenty years of infectious disease dynamics research: gender and race imbalances in publication and citation practices. Proceedings of the Royal Society, B, 292(2050):20250960, 2025. 8 [18] Lotta Velin, Jean-Wilguens Lartigue, Samantha Ann Johnson, Anudari Zorigtbaatar, Ulrick Sidney Kanmounye, Paul Truche, and Michelle Nyah Joseph. Conference equity in global health: a systematic review of factors impacting LMIC representation at global health conferences. BMJ Global Health, 6(1):e003455, 2021. [19] Gregor Wolbring and Annie Nguyen. Equity/equality, diversity and inclusion, and other EDI phrases and EDI policy frameworks: A scoping review. Trends in Higher Education, 2(1):168–237, 2023. A. Appendix: Context-specific Best Practice Posters 9