A crisis of trust and what we can do about it
By Elizabeth Ashbourne, PQMD Executive Director
One of my favorite expressions is that trust comes in on a turtle and rides out on a horse. Trust is hard earned and should never be taken for granted. It can only be gained through a demonstration of genuine commitment to shared and well-articulated goals. Whether it’s in a relationship with a neighbor or a global agreement to achieve universal health care, it doesn’t take much to get that horse out of the stable.
Trust is an essential element in healthcare. We need people to listen to public health experts when it comes to precautions about a disease, the need for vaccines, the basics of maternal and child health, and so much more. Individuals need to have confidence in their governments, and have faith in public institutions, policies, and healthcare providers. Yet for the past few years, trust in institutions and their leaders has steadily declined, within the U.S. and around the world. This trend has significant implications when it comes to the rise in global threats like climate change, conflict, mass displacement, pandemics, and poverty—all of which impact individual and public health.
According to the 2024 Edelman Trust Barometer Global Report, which polled 32,000 people across 28 countries, across multiple sectors, about who they trusted, government leaders didn’t fare well. Sixty-three percent of respondents ranked governments as untrustworthy, as well as less ethical and competent than NGOs and business. This is especially problematic for public health, since governments develop and promote national health strategies and programs that provide lifesaving resources. It is governments that people depend on to implement health services, albeit in partnership with global and national institutions, development agencies, faith-based organizations, private sector actors, non-government organizations (NGOs), community health workers, and / or individual health practitioners.
So, as a global health community, what can we do about this? How can we contribute to convincing populations that responses to global escalating crises, particularly those that have significant health impact, are being undertaken with the best intentions?
Perhaps the Edelman Trust Report can also give us a path forward since the findings do reflect that the private sector is seen as the most competent and NGOs are seen as the most ethical. This data provides an opportunity to demonstrate that multi-sector partnerships are effective and can be trusted to provide quality health service delivery.
Given this information, organizations like Partnership for Quality Medical Donations (PQMD)—a unique coalition of global non-profits and corporate organizations dedicated to providing access medicines and healthcare—can by design, contribute to stemming the tide of waning trust in government.
Each of the 53 organizations within PQMD can provide examples of how working hand-in-hand with governments on country-based recovery and resilience activities has been key to building and maintaining success and long-term trust in their programs and their partners. And as a community, we’ve learned a few lessons to share:
- Show trust in order to be trusted;
- Be transparent—make it clear what actions are being taken and why—and be consistent with what is said and done;
- Be authentic and empathetic, make sure that beneficiaries aren’t feeling like they are just being checked off a list; and most importantly,
- Provide hope and reassurance that what is being done will make a difference.
It is certainly not revelatory to say that no sector can solve any global crisis on its own, let alone a national one. Nor is it new to know that trust is essential in order for the global health community to do the essential work it does. However, if global focus, funds, and declarations are not enough—and I don’t think they are—and trust in governments and institutions continues to decline, then we all need to redouble our efforts to align our actions with our words. We need to show people that by being inclusive and working in partnership at all levels, we will never stop working to earn their trust.
More about the blog series and the author
I started this monthly blog series to (hopefully) spark discussion around the challenges and opportunities to delivering global healthcare and access to medicines in our current environment. PQMD facilitates collaboration among its member organizations and seeks to continuously support the delivery of high-quality donations of pharmaceuticals, medical equipment and services to communities in need. Members have the opportunity to exchange and share their knowledge and experience with providing medicines and medical services to the people who need them most, in the US and around the globe.
The series will be informed by my more than 25 years of experience in leading, planning, and implementing national and global programs in communities and countries worldwide. I’ve worked in the private sector, public / development sector, NGO, FBO and local organizations, along with living in countries during war time, peace time, in extreme poverty, and with great wealth. I’ve led CEO roundtables at global forums and community leadership circles sitting in the grass under a tree. I’ve managed large scale foundation relations, international and local corporate partnerships, organizational design, communications, outreach and education campaigns, and small- and large-scale coalition building around public and private sector management. My specialties include public-private partnerships in global health, environmental, education, and social development.
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