Trust and transformation: an agenda for creating resilient and sustainable health systems

Health systems are facing unprecedented challenges as they emerge from the covid-19 pandemic. How they have responded has varied greatly. Just as with SARS in 2003, when some Asian health systems redesigned facilities to be better prepared for a future pandemic, 1 we have seen new ways of working, often taking advantage of new means of online engagement. 2 But some have also struggled, unable to rebuild workforces that were already depleted by underinvestment, but with the additional burden of burnout 3 and illness, including long covid. 4 This situation, in part, reflects and is exacerbating a crisis of trust. 5 This is apparent in three important sets of relationships.