The idea of the social contract as we understand it today first took root in the Age of Enlightenment. It was enshrined in a book by Jean-Jacques Rousseau of 1762, which examined the relationship between natural and legal rights. Today, we talk about a ‘social contract’ between business and society. The theory being that businesses exist with the permission of society, and that this permission is dependent upon business acting in a way that benefits society. 

You might assume that as an industry whose purpose it is to heal the sick and keep people well, healthcare would be on the side of the angels. Surely, the pharmaceutical industry, which primarily exists to develop and manufacture products which promote good health, intrinsically benefits society and so has an iron-clad social contract. 

Our 2022 Trust Barometer Special Report: Trust and Health, conducted in February this year, paints a more complicated picture. Tracking among the study’s global average of nine countries, the survey saw trust in healthcare companies fall to 62 percent, compared with 73 percent in May 2020, at an earlier stage of the COVID-19 pandemic. Meanwhile, trust in the pharmaceutical sub-sector is slightly below at 61 percent. This is an encouraging rise from 55 percent just ahead of the pandemic in January 2020. But even with the role played by pharmaceutical companies in the development, manufacture and distribution of life-saving vaccines and treatment, the pharma industry remains tied with consumer health as the least trusted of all the sub-sectors surveyed. The highest sub-sector levels of trust are at 76 percent, for both hospitals and local pharmacies.

If pharma cannot build widespread trust by fulfilling its core purpose, and doing it in a high-profile way that helped the entire world, how can it build trust? Our new research, which tracks a broad range of both public and personal health issues, offers some potential answers.

A high number of respondents, 65 percent, say that there is a gap between how well they are currently taking care of their health and how well they should be. Cost is the most commonly cited reason keeping people from closing this personal health gap (cited by 50 percent). But the second most common reason (47 percent) is about information: lack of health information and confusion caused both by recommendations changing frequently and contradictory guidance from different health experts.

The report highlights a growing societal consensus that health companies (which, of course, includes the pharma industry) should engage publicly on key issues facing the larger health ecosystem. On average, 73 percent say it is important to earning or keeping their trust that health companies play a role in ensuring access to high quality healthcare; 71 percent say health companies must build/maintain trust in their country’s health system to earn or keep their trust; and 69 percent say health companies must address pollution to earn or keep their trust.

So here may be a means by which the pharmaceutical industry can renew, and even strengthen, its social contract: By engaging more with the health-related issues of most concern to society today and helping to overcome the various challenges that prevent so many from living healthy lives. For example, if the lack of credible, consistent information is a barrier to people achieving the level of wellness they aspire to, pharma companies could mobilise their extensive resources to help — including by being a resource for credible, accurate and reliable information on health conditions and treatments.

Some pharmaceutical companies will say that they are already working in some of these areas. However, often this will be ESG-type initiatives such as the donation of medicines to disadvantaged communities. These projects tend to be relatively small in scale and do not form part of the core activity of the business. This may be due to concern around going outside their core remit and fear of a negative reaction should they stray beyond the bounds of their traditional sphere of operations. 

However, society is reeling from two years of trauma and mental and physical health is firmly in the spotlight. Healthcare systems across the world, and those who work within them, have been stretched and strained like never before. Help is desperately needed to get them back on their feet. It is clear from the results of the new study that solutions will be hugely welcome, even if they do come from a previously unexpected direction.

Carolyn Paul is Chair of Health for our EMEA operations.