The strength of nations and their governments are under the spotlight with SARS-CoV-2 – some have risen to the challenges; others have faltered with dire consequences. Ian Burgess, CEO, Medical Technology Association of Australia and Professor Stephen Duckett reflect on Australian leadership through the crisis and some of the lessons for future political and governance reform. Keeping healthcare affordable is a major focus in this issue. The economic onslaught of the pandemic will leave millions in financial dire straits adding to the numbers already struggling with the burden of healthcare costs. A heartfelt thank you to all those at the frontlines and behind the scenes who have cared for us and fellow global citizens.