Leadership across difference: Trust as the currency of collective action

About the author:

Olukayode Fasominu is a Public Health Physician & Management Consultant. He currently serves as Managing Partner at Volte Health, where he spearheads engagements with governments and development partners across Africa on strategic investments in healthcare in the public and private sectors.  He is a graduate of the University of Ibadan, Cardiff University and the MSc in Global Healthcare Leadership at the University of Oxford; he enjoys watching football and making scholarly contributions on a wide range of subjects.

This piece is a response to Professor Kamal Mahtani's blog for our MSc in Global Healthcare Leadership (MGHL) Cohort 2, published following our graduation ceremony in May 2026. Kamal's blog examines one of leadership's hardest responsibilities: guiding diverse groups through complexity without demanding uniformity of thought. His central premise stays with me. Effective leadership does not create universal agreement. It enables people to contribute meaningfully despite their differences. That premise may resonate deeply for those of us working in global health and development, and at its core it is a question of stewardship: how leaders hold trust across difference.

Even after completing the MSc in Global Healthcare Leadership programme, its modules remain instructive. Reading Kamal's blog, I found myself returning to the first two modules of our programme on healthcare leadership and organisational leadership.

Module 1 argued that leaders must lead within context. That context comes from understanding culture, and just as importantly, from understanding what drives a person to lead. For me, personality is the most relevant factor here – ambition, situation, environment, history and capability all shape it. Together, they form the basis for building and entrenching trust. Leading change in the challenging circumstances global health presents today depends on getting this right.

Module 2 offered an equally instructive message: strategic leadership is a process, not a position. Trust must be built throughout that process, especially while navigating uncertainty in turbulent environments. This played out directly in a recent government-to-government negotiation in my role at Volte Health, where our team advised high-level government stakeholders and development partners on a multibillion-dollar strategic health investment, and where my team were responsible for developing a multiyear implementation strategy for the health investment. The stakes were high, and getting stakeholders aligned mattered as much as getting the technical answer right.

Treating strategy as a process, not a position, shaped how we approached it. We built a model to select implementation sites, drawing on programme data from multiple stakeholders, each holding different sources, convinced their own was authoritative. The breakthrough came from weighing every credible data source on its merits and building one shared source of truth. That shared foundation gave the model its validity, moved the strategy process forward and brought every party to agreement on the final output.

These challenges often extend far beyond universities. Across healthcare systems, multilateral institutions, ministries, donor organisations and implementing partners, leaders navigate spaces where values, incentives and perspectives do not align. Leaders work at the intersection of science, politics, culture and economics, domains that often pull in different directions.

Kamal rightly notes that leaders must hold multiple positions in tension at once. This is one of the most underappreciated realities of leadership. In healthcare, these tensions surface daily: rapid delivery against safeguarding quality, local ownership against external funding expectations, scale against context. These tensions are rarely fully resolved. They must be managed with discernment.

Technical competence is necessary, but unfortunately most of the time, it is insufficient. Trust is the differentiator.

Trust is often treated as an abstract virtue, but in practice, it can be tangible. It can shape whether teams speak honestly, whether dissent surfaces early, whether risks are escalated and whether difficult decisions are accepted even when unpopular. Trust can determine whether institutions hold together under pressure.

Kamal's distinction between agreement and understanding is powerful. Leaders too often equate dissent with resistance or disloyalty. Disagreement is not inherently dysfunctional. In complex systems, constructive disagreement is a source of resilience and innovation. Homogeneity of thought often creates comfort and entrenches groupthink. It rarely produces robust solutions.

The real task of leadership is to create environments where disagreements are handled with care and where people are heard even when their view does not prevail. This requires a discipline of listening.

Listening is often called a 'soft skill', but that language understates its strategic importance. Deep listening demands intellectual humility. Leaders must set aside certainty, resist the impulse to be defensive and genuinely engage with perspectives that challenge their assumptions. This can be difficult because leadership rewards decisiveness over deliberation. Yet better decisions often come when leaders make room for voices unlike their own.

This lesson carries weight in global health and development work. Some of the sector's greatest failures have come not from poor intentions, but from poor listening – when solutions are designed far from the communities they serve. Programmes fail when strategy ignores context. Trust breaks when participation becomes performative instead of substantive.

People do not expect leaders to satisfy every interest. They expect fairness, transparency and respect. As Kamal notes, people can disagree with an outcome and still trust leadership if they believe the process was credible and their perspectives were genuinely considered.

Returning to the ideas raised at the outset, this is where leadership moves towards stewardship over authority. The most effective leaders do not dominate the room. Instead, they curate environments where candour is safe, challenge is welcomed and shared purpose stays stronger than individual difference. These lessons continue to resonate with me, a direct result of the thinking Module 1 and Module 2 of the MGHL programme instilled; that context and personality shape how trust is built, and that leadership itself is a process, not a fixed position. Long after graduation, that teaching keeps proving its value.

In increasingly polarised times, this form of leadership is indispensable.

Diversity of background, discipline, ideology and lived experience often generates friction. Under the right conditions, that friction produces insight, innovation and growth. Without trust, the same friction produces fragmentation, and trust becomes the bridge between diversity and collective progress.

Leadership built on trust asks us to lead with conviction without becoming rigid, to listen without surrendering judgment and to hold difference without allowing division.

Trust may be one of the defining leadership capabilities of our time.

The true test of leadership is not making everyone agree. It is helping people stay committed to a shared purpose even when agreement remains elusive.

That is the work of trust, and perhaps the highest calling of leadership.