An important goal of global health is to advance health equity for all people worldwide. Trust in global health research, practice and policy is crucial for achieving this goal. In this plenary we start by examining the historical roots of mistrust in global health, citing examples of research abuses and barriers to the delivery of care in marginalised communities. This is followed by a discussion of challenges for evidence generation, synthesis and use encountered during the COVID-19 pandemic. Next, we shift our focus to the impact of the profit motive on trust and equity in health and offer guidance on the conduct of systematic reviews focussing on the commercial determinants of health.  We conclude by providing recommendations for improving research integrity and building trust in global health research.