Lucy Gilson holds a joint appointment at the School of Public Health and Family Medicine, University of Cape Town and the Department of Global Health and Development, London School of Hygiene and Tropical Medicine. Her research broadly focusses on how to strengthen health systems to offer better public value, with particular concern for health equity. She also has interests in understanding health system actors’ decision-making, and how trust and power relations shape health system dynamics and complexity. She is a board member of Health Systems Global, and co-research director of RESYST — the Resilience and Responsive Health Systems research consortium — which conducted the research underlying this piece.