parameters of public health laws and still allow flexibility for local
innovation and norm-setting. With effective communication and evidentiary
support, innovations in public health policy can spread and improve across
jurisdictional boundaries as a direct consequence of complementarity.
Despite efforts to reach the harmonization described above, public health
systems have not routinely achieved normative consistency across
overlapping and duplicative systems. Indeed, the multiplicity of participants
and concurrent legal regimes in public health governance may provoke
tradeoffs between flexibility and consistency, or between innovation and
harmonization. Normative and procedural harmonization can be compatible
with other aspects of complementarity such as innovation, flexibility, and
systemic resilience through the use of collaboration and communication.
Through the employment of dialectical tools, common normative and
procedural approaches to public health governance can be shared and
improved.121 Additionally, with further research, a more extensive typology
of redundancy and complementarity in public health governance can
developed and assessed.
Since Landau first challenged the presumptions against redundancy over
40 year ago, his observation stands true: “[T]he task remains to learn to
distinguish between inefficient redundancies and those that are constructive
and reinforcing—[including] the kind of knowledge which will permit the
introduction of redundancies so that they can work to increase both reliability
123. R. Chad Swanson et al., Rethinking Health Systems Strengthening: Key Systems
Thinking Tools and Strategies for Transformational Change, 27 HEALTH POL’Y & PLAN. 54