Bracing for the next pandemic: A qualitative One Health study of stakeholders’ and communities’ perspectives on infectious disease risks and prevention on Aruba

Background Infectious diseases remain a global health concern, with outbreaks like dengue virus (DENV) and COVID-19 illustrating ongoing threats. Aruba faces heightened vulnerability due to tourism, climate-sensitive vector dynamics, and reliance on animal imports. For efficient response to public health crisis, it is imperative to understand major infectious disease risks, and how stakeholders and communities perceive and respond to these risks. Methods In 2024, in-depth interviews and focus group discussions (FGDs) were conducted with community members and stakeholders from different sectors, e.g., public health, veterinary services, waste management, pest control, environmental organisations. Discussions explored perceptions of infectious disease risks, surveillance gaps, and prevention challenges. Community members were recruited through voluntary response sampling, while snowball sampling identified key stakeholders. We first developed a codebook based on the One Health framework. Thematic content analysis was subsequently conducted using Atlas.ti. Results Thirteen interviews and seven FGDs were conducted among 20 community members and 26 stakeholders. Vector-borne diseases were of concern, particularly DENV, among community members and stakeholders. Current prevention strategies include e.g., personal hygiene, animal care, vaccination, vector control, and import regulations. The need for enhanced collaboration and data-sharing between health sectors was highlighted by stakeholders. Conclusions To prepare Aruba for the next pandemic, it is recommended that policymakers invest in building financial and human resource investments, in order to strengthen centralised digital surveillance, expanding notifiable diseases, multilingual medical outreach, mapping vector hotspots, and formalising One Health coordination across health sectors.