Trust, transparency, and accountability in health and pharmaceutical systems

Abstract Trust is essential for the effectiveness of public health and pharmaceutical systems, ensuring the availability of safe, effective, and affordable medicines globally. The COVID-19 pandemic highlighted the critical role of public trust, showing how its erosion can undermine health efforts, leading to increased vaccine hesitancy and the adoption of ineffective or unsafe remedies. Trust enables collective action, crucial for public health measures, and public support for policies improving medicine access depends on trust in pharmaceutical companies’ commitment to fair and affordable pricing. This thematic collection of the Journal of Pharmaceutical Health Services Research explores the importance of transparency and accountability in pharmaceutical systems. Addressing corruption risks and conflicts of interest is vital to ending health inequalities and ensuring the legitimacy and epistemic authority of health systems. This thematic collection aims to advance the dialogue on the necessity of transparent and accountable health and pharmaceutical systems that are trustworthy and to deepen our understanding of potential trust cleavages within these systems.