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This paper elaborates a ‘pathways approach’ to addressing the governance challenges posed by the dynamics of complex, coupled, multi-scale systems, while incorporating explicit concern for equity, social justice and the wellbeing of poor and marginalised groups. It illustrates the approach in relation to current policy challenges of dealing with epidemics and so-called ‘emerging infectious diseases’ such as avian influenza and haemorrhagic fevers, which involve highly dynamic, cross-scale, often-surprising viral–social–political–ecological interactions. Amidst complexity, we show how different actors in the epidemics field produce particular narratives which frame systems and their dynamics in different ways, promote particular goals and values, and justify particular pathways of disease response. These range from ‘outbreak narratives’ emphasising threat to global populations, to alternative but often …