The crisis has revealed how inadequate some health care systems are, even within the developed world. Countries that are used to being labelled ‘developing’ are watching askance as economies like the US, the UK and Italy struggle to contain the pandemic. We see how much a nation’s economy depends on the capacity and resilience of its health and social care systems, the dedication and skill of those who work in them, and the reach of the global supply chains for medicines and equipment. The urgent collective need to develop testing and vaccines is prompting unprecedented collaborations among pharmaceutical companies, universities and governments. How should health and social care systems change as a result of the pandemic?