Falcone and colleagues have stated that one of the most central aspects of the Covid-19 pandemic is based on a "crucial psychological, relational, and political construct: trust". This sentiment was most certainly felt by all the participants at the first session of the Project for Peaceful Competition conference series, which began with a debate on health systems globally. Just like the Beatles’ song "All You Need is Love", the conference participants replied, “Trust is all we need!”.

Throughout the Covid-19 pandemic, the scientific community has had to reimagine how to proceed in the future, for the betterment of the health of everyone on the planet. But, before this can happen, problems need to be identified and solutions need to be found. This has forced countries, governments, multilateral organisations, citizens, health professionals, and scientists to look to the status of their health system like no other public health crisis has done before. We are facing a complex emergency that ties together the emergence of many different complexes. It is now time to reflect upon this.

The theme of the conference was “Handling threats to global health in a multi-polar world” and the first session centred around the current issues of the day. From climate change and its impacts on health, to the importance of non-communicable diseases, to the problems of infrastructure and communication systems. And the keyword of the first day of the conference was trust – the need for it, and the lack of it. Some of the common problems we discussed were: signals and warnings that were either ignored or delivered late; responses not given in time; inefficient and insufficiently update structures. In the session, we considered the importance of informal links in light of the need for separation between technical scientific expertise and the politics or political appropriation of health. There was also a call for new forms of health security and epidemic intelligence, similar to some already being proposed, but exposing current failures and built around think tanks that break existing siloes.

In the second session – Possible solutions – we continued the themes of complexity and interdependence in our discussions about diseases, threats, and solutions and how to take a systems-based and systematic approach to health. The pandemic is only one of the threats that we are facing together and in different societies, simultaneously. Of the threats we discussed, broader development issues in health, poverty, economic and political vulnerability, and insecurity; warning systems’ failures; and the drain of medical professionals or "brain drain" emerged as the main discussion points. Some of the solutions we discussed included: the role of aiding technologies; political willingness to offer more support but also allow more autonomy to the scientific community;  engagement from the private sector; better public communication and the focus on social and health protection.

The mapping of differences, inequalities and shared responses to these challenges are the responsibility of governments and people alike, but without trust amongst and between these two groups, obstacles to progress in the health domain are going to increase. Fragmentation is already upon us and the future of our planetary health depends on this reflection.

 

Carla De Utra Mendes is a Postdoctoral Research Associate in China and Mental Health at Lau China Institute, King’s College London.