Navigating evidence-informed decision making for arboviral disease control in Pacific Island countries.

Arboviral disease control is a priority for Pacific Island countries (PICs), where dengue outbreaks occur frequently. This perspective applies the World Health Organization (WHO)'s evidence-informed decision making (EIDM) framework to examine opportunities and challenges in generating, translating and using evidence to guide arboviral disease control in PICs, using the Wolbachia mosquito release intervention as a case study. The implementation of Wolbachia in several Pacific countries was achieved in the absence of a comprehensive evidence ecosystem, highlighting gaps in EIDM processes. In particular, limited local evidence on intervention effectiveness, combined with challenges in disease surveillance, data accessibility and entomological monitoring, has hindered robust evaluation of public health impact and decisions on scale-up and sustainability. Opportunities exist to strengthen EIDM through pragmatic use of existing surveillance data, time-series analysis and serological studies to assess impact. An untapped reservoir of tacit evidence can be harnessed through culturally appropriate methodologies, such as Talanoa, to contextualise scientific data and address gaps in qualitative research. Closer connections between evidence generators and users can facilitate more effective collective decision-making in Pacific settings. The WHO EIDM framework is useful for Pacific populations to chart pathways towards improved arboviral disease control, with pragmatic considerations of its application in Pacific contexts. Enhanced collaborations and transdisciplinary programs offer further opportunities to align interventions with regional health priorities for integrated EIDM. Policy dialogues using culturally appropriate approaches and leveraging the advantage of simpler systems can greatly improve the efficiency of knowledge translation pathways for EIDM in PICs.