In the heart of Switzerland, the PharmaLedger Association, established in March 2022, is a testament to the power of collaboration. Born from the PharmaLedger project, which spanned from 2020 to 2022, this not-for-profit Association is the fruit of a remarkable public-private partnership. It brought together pharmaceutical giants and EU public partners, a diverse coalition comprising hospitals, universities, patient organizations, and technology firms. Their shared vision: to revolutionize healthcare through cutting-edge blockchain technology, laying the groundwork for a Digital Trust Ecosystem in Healthcare (DTE-H). At its inception, the association’s focus was centered on leveraging blockchain technology to create this Digital Trust Ecosystem in healthcare. However, as the project unfolded, it became evident that it was less about the technology itself and more about the vital elements of collaboration and trust. The foundation of this ecosystem is rooted in the digital, grounded in trust, and fundamentally bolstered by blockchain technology, though the focus has since pivoted primarily to these core values. The journey hasn’t been without its challenges. Bridging diverse stakeholders, from pharmaceutical industry experts to academia and healthcare providers, was certainly an early hurdle. Yet, by fostering a culture of collaboration and mutual respect during the project’s planning phase, these seemingly distinct entities found common ground. Each voice, regardless of the organization’s size, was heard, respected and valued resulting in remarkable outcomes and meaningful progress.