While it is difficult to predict the future of disaster health management, we can at least reflect on the challenges and opportunities faced by disaster managers and communities affected by disasters. Modern societies are incredibly complex and dependent on interconnected socio-technological systems which create tremendous opportunity by creating improved services and products, while at the same time potentially increasing vulnerability. The same is true for disaster management. Leaders and managers face diverse challenges characterised by an increasingly complex environment making performance and accountability more difficult. However, it does provide remarkable opportunities to achieve better outcomes in a climate of minimal tolerance for failure.