Models meet reality? TB meets HIV


A recent letter to the Lancet argues that mathematical modelling on cost-effectiveness of tuberculosis control efforts fail to account for real-world challenges: “Political determinants such as … political disruptions, migration, poverty…which are at the root of existing tuberculosis and emerging anti-tuberculosis drug resistance in the world.”

Sachin Atre and D.Y. Patil argue that this failure of mathematical models, which are increasingly used to plan and allocate resources for TB programs, may have something to do with the growing global burden of TB.

I made a similar argument in a letter to the Lancet HIV last October: that mathematical modelling of HIV prevention interventions failed to “consider how laws and their enforcement impede access”–especially for sex workers and men who have sex with men in Nigeria and South Africa, who risk arrest if they carry and use condoms and lubricants.

Our letters to the editors of the Lancet aren’t reducing the growing dominance of mathematical modelling in global health governance, but it’s good to know there are other scholars out there scratching their heads when they see the hyper-optimistic scenarios painted by statisticians.

And on a lighter and unrelated note, here’s a delightful chart from Spurious Correlations for your next forward-looking slide deck — more at

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