ABSTRACT
This chapter aims at reflecting on some puzzling issues regarding the Global Health System that have been present throughout our empirical data collection. Scholars have pointed towards the complexity of managing such an open system. This chapter goes back to some of the basic characteristics of the Global Health System and asks the question: under what conditions can the Global Health System actually be considered a system? While doing so, we also focus on one of the key features of the Global Health System: namely, the incomplete model for public health interventions during epidemics. Regularly challenged, notably by social scientists, this model raises particularly several organizational design issues. To better address these design flaws, we propose borrowing from the literature on high reliability organizations. Finally, the chapter concludes by arguing for fewer calls for more structure, more control and more reforms and for more decentralized responses in health crises, which rely on local expertise of all kinds, including the expertise of victims.
