Now, what? Are we ready to meet common challenges, together?

 The use of a standardized structured format, with key questions as the main drivers for content development in all chapters, also paid off. The book not only provides easy access to the best available knowledge on 10 major aspects of polypathology but also a long list of unaddressed questions and issues that require urgent attention.

We feel that the collaborative work that resulted in this book could easily become the foundation for joint projects that could fill many of the identified gaps, in record time.

The following are some examples of questions that could drive the design, execution and dissemination of large-scale collaborative projects through which we could attempt to meet the challenges created by polypathology, at all levels:

- Is it possible to promote an ongoing global survey to monitor polypathologies in different regions of the world simultaneously?

- Is it possible to create a taxonomy that could facilitate the exchange of knowledge and the evaluation of innovations for the management of polypathology worldwide?

- What strategies or interventions are needed to facilitate the development of the knowledge base, attitudes, skills and behaviours required by professionals to bridge social and health services in a way that would contribute to meeting the unmet methodological, technological, management, social, political and economic needs associated with polypathology?

- Are polypills cost-effective interventions for polypathologies? If so, how can their widespread use be encouraged?

- Is it possible to design, implement and evaluate a flexible model of care that brings together the power of de-centralized innovation and leadership by front-line professionals and the public, with the efficiency of a centralized policy-making and management structure?

- Is it feasible to use online social media to create and sustain a global network of self-management and peer-to-peer resources for people living with multiple chronic diseases?

- What are the new functions or whole occupations or the new roles for existing occupatoins that are required to bridge or blend social and health services in a way to that would meet the needs of people living with multiple chronic diseases and their caregivers?

- To what extent could effective innovations for the management of polypathology be adopted and adapted across different regions of the world?

- How do different combinations of diseases or disease trayectories influence the supportive and palliative care needs of people with polypathologies and their caregivers?

- What is the impact of multiple chronic diseases on the lives of caregivers? What new roles, workflows and supportive services are needed to relieve their burden?

- Could Integrative Medicine promote the demedicalization of the management of polypathologies? Could it promote greater acceptance, among patients and caregivers, of the unavoidable suffering associated with multiple chronic diseases and the ageing process?

- What are the total costs associated with the management of polypathologies?

- Does the level of complexity associated with most polypathologies exceed the capacity of GRIN technologies to offer tangible solutions?

- Could key regions be transformed into living laboratories with the conditions necessary for the development, refinement, implementation and evaluation of innovative ways to optimize the management of polypathology?

- What strategies are needed to position the management of polypathology among the top priorities for leading political, academic, community and corporate organizations interested in the sustainability of the health system?

Answering these questions, and many others that remain unaddressed, will not be easy. It will require a very creative blend of public engagement; creative partnerships among the government, academic institutions, the public and industry; rigorous transdisciplinary research and development; strong input from social and political scientists; visionary technological innovation; effective knowledge mobilization and management; and extraordinary political will.

 Such effort will require unprecedented levels of generosity to overcome the powerful perverse incentives that have made us so vulnerable to polypathology.

We have already proven, by co-creating this book through OPIMEC, that we can work across traditional boundaries, contributing to a common ambitious agenda. We must now scale up the level of our commitment to create and implement the potent interventions that are required to overcome the apparently insurmountable challenges we face, together.