Keynote lecture: Dr. Soraya Verstraeten

From Cells to Systems: a Journey of Evolving Questions in Caribbean Health Research

This keynote tells the story of a research journey shaped not by fixed answers, but by changing questions. It begins with a simple, fundamental inquiry: why do individuals get sick?, and follows how that question evolved in response to new evidence, new methodologies, and the lived realities of the ABCSSS-islands. Along the way, one insight became clear: the questions we choose to ask define not only what we study, but the impact our work can ultimately have.

Each next question was driven by the limitations of the previous one. Biomedical research uncovered critical insights into disease mechanisms but could not explain why entire populations experience different health outcomes. Population health studies revealed striking disparities and the importance of preventable and amenable conditions. Looking across the Caribbean, comparative research brought into focus the powerful role of governance, institutions, and policy performance. Yet even with this knowledge, real-world prevention efforts exposed a well-described gap between evidence and action, shifting the focus toward quality improvement.

This research journey -from cells to systems- illustrates that improving health in small island contexts requires continuously reframing our questions to match the levels at which health is shaped. It calls for bridging disciplines, from biomedical sciences to public health and implementation sciences, to build health systems that not only deliver care, but learn to adapt and improve over time.