Agent-based models of malaria control in the vaccine era: a systematic review of WHO GTS 2016–2030 target alignment

The World Health Organization adopted the Global Technical Strategy 2016–2030 (GTS) to guide national malaria programmes towards disease control and elimination. More recently, WHO also recommended two malaria vaccines, further expanding available intervention strategies. Agent-based models (ABMs) are well suited to evaluating these interventions; however, whether the ABM literature is aligned with GTS targets and captures key biological, epidemiological, and health-system features has not been systematically evaluated. To classify malaria ABMs according to their modelling characteristics, biological, epidemiological, and health-system features, assess their methodological quality and credibility, and evaluate how modelled interventions, including vaccines, inform progress toward the WHO GTS 2016–2030 targets. We searched Web of Science and Scopus, restricting the review to English language studies published between 2022 and 2025. Five reviewers independently screened studies and extracted data. Models were classified by agent type, framework, computational platform, spatial structure, and biological, epidemiological, and health-system model features, while interventions were categorised according to their mechanisms of action. Methodological quality was assessed using a seven-domain risk-of-bias instrument adapted from the ISPOR–SMDM Modelling Good Research Practices guidelines. Twenty-three studies were included in the review. Dual-agent models and stochastic agent-based models each accounted for 70% of the studies, whereas custom stochastic IBMs and the OpenMalaria platform each accounted for 30%. Biological, epidemiological, and health-system model features were unevenly represented across studies, with climate forcing (30%) and drug resistance (26%) being the most frequently incorporated. Chemotherapy remained the most frequently modelled intervention (52%). Overall, 61% of studies were rated at low risk of bias, although only four studies (17%) achieved external validation against independent data, and four studies (17%) explicitly reported GTS alignment. The synthesized studies provided important insights into malaria management but did not establish a generalisable pathway for achieving the WHO GTS targets. However, the three studies incorporating vaccine components reported that the GTS 90% reduction target was nearly achievable, highlighting the potential of vaccine-integrated strategies. Further research is needed to validate their effectiveness for achieving the WHO GTS targets.