Summary 

Trust and solidarity are centrally important to the functioning of healthcare systems, and for societal resilience and stability more broadly. The European Union is increasingly shaping governance and norms that affect trust and solidarity in health—a process that has intensified with the announcement of the ‘European Health Union’ in response to the COVID-19 pandemic. In this context, how can the EU ensure solidarity in health while generating public trust as a pre-condition for solidaristic institutions? We propose three strategies to reach this goal. First, both at national and European levels, institutions and mechanisms of solidarity should be strengthened. Second, the Union should boost the resilience and stability of national healthcare systems through mechanisms of risk-sharing. Third, the Union should mandate or encourage its member countries to enhance prevention and other public health policies to strengthen pre-distribution, aimed to ensure a more equal baseline of public health before inequalities arise.