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Believing is like blinking. Both are there for our self-protection and occur so frequently we barely notice them [1]. Like any of our other mechanisms to protect ourselves, the presence and power of our beliefs become apparent once they fail. Only at that point, we recognize their essential value in helping us contain the challenges we encounter, constantly, throughout our lives. Challenges that manage to break through our belief systems are usually the most serious. They are often existential threats, which confront us with our mortality.

What we often overlook is that, when we face such threats, our beliefs can turn against us, morphing into weapons of mass destruction, directed at the very foundations of our way of life. We are now facing an unprecedented belief crisis, one in which our inability as a species to agree about what is credible, and whom to trust, is growing. The depth of this crisis is reflected in how easily ‘fake news’, conspiratorial thinking and misinformation can overpower scientific evidence. This is weakening our capacity for sense making and collective action around policies to curb major challenges to human survival such as pandemics or climate change [2, 3].

The belief crisis is being hastened by the complicity of people holding positions of power. At a time when they are expected to act as trustworthy leaders capable of joining forces across ideological, geographical, cultural, and sectoral lines, most of them are reacting as mere custodians of the resources in their political, corporate, or academic purview. Thus, they are squandering a historical opportunity to muster a unified, strong, fair, transparent, accountable and effective response to secure our continued presence on the planet, leaving in their trail a panoply of disappointing decisions that in many cases are blatantly incompetent, ignorant, negligent, malicious or corrupt [4].

The most concerning sign of the crisis is the erosion of trust—a social emotion that depends on the belief that others are reliable and will act benevolently [5, 6]. Surveys have been showing consistently that less than half of people worldwide trust their government agents, journalists, corporate leaders, and even physicians and nurses [7,8,9].

Curiously, despite their active and essential involvement in efforts to curb existential threats, public health professionals have remained out of the public eye. This is reflected by the apparent absence of studies about how much they are believed or trusted, and by their own reports about feeling invisible [10]. Such invisibility, which could easily be regarded as a weakness, might end up being the strongest suit for the public health community in these critical times. Indeed, the behind-the-scenes and unassuming ‘in-betweenness’ that characterizes most public health professionals is what places them in a privileged position to provide the dependable links that are so badly needed to rebuild and nurture trust at all levels and across all sectors.

The question is whether public health experts are able to believe that they might be the only large enough group left with the capacity, knowledge and trustworthiness required to fulfill this crucial role, so that we could adapt and thrive, even if there is nothing that could be done to revert or stop the challenges themselves.

Let’s hope they are.


Alejandro R. Jadad, MD, DPhil, FRCPC, FCAHS, FRSA, LLD; Founder, Centre for Digital Therapeutics, Toronto, Canada; Member, Public Health Leadership Coalition, World Federation of Public Health Associations.