Not all MDAs should be created equal – determinants of MDA impact and designing MDAs towards malaria elimination

Malaria remains at the forefront of scientific research and global political and funding agendas. Previous malaria models of mass-interventions have consistently oversimplified how mass interventions are implemented. We present an individual based, spatially explicit model of malaria transmission that includes all the programmatic implementation details of mass drug administration (MDA) campaigns. We uncover how the impact of MDA campaigns is determined by the interaction between implementation logistics, patterns of human mobility and how transmission risk is distributed over space. This translates into a higher likelihood of malaria elimination for areas with true prevalence under 3% with a faster implementation, in highly mobile populations. If populations are more static, deploying less interventions teams would be cost optimal and predicted to be as impactful. We conclude that mass drug interventions can be an invaluable tool towards malaria elimination in the right context, specifically when paired with effective vector control.