We are in an exciting time in medicine. Many new medications will become game-changers, and more and more technologies are allowing miracles to be performed, in the dark, through keyholes. These medications and technologies alone however will not be enough to fully curb the global burden of disease, and achieve better health and well-being for all who live with chronic diseases. Also important for achieving these goals is the gaining, deserving and maintaining of a patient's trust, by their clinicians and their health systems. As societies, we need to move on from the paradigm of medical paternalism to explore and achieve true care partnerships. People living with chronic diseases manage their disease every day, their interaction with the health system is intermittent – they are therefore their own primary health care givers. As such it is important to recognize that each patient is their own best "expert". A true care partnership will be one where the clinician and the patient come together as "experts" on equal footing, to carve out the right route together through the chronic illness, by identifying goals and obstacles, and understanding perspectives. Medical paternalism may still have a role in some settings, but in general, the building of effective care partnerships is more holistically aligned with all of the biomedical ethics principles - autonomy, promoting benefit, avoiding harm, and achieving fairness. In Africa there is a well known saying "umuntu ngumuntu ngabantu" - a human is a human because of other humans. This highlights how we cannot thrive as individuals. Clinical medicine is breaking down more and more technical barriers – to retain the humanity in medicine we need to function as communities and partners to collectively continue to strive towards achieving the highest attainable state of health for all.
