This chapter applies Pragmatic Constructivism to assess communities of practice in global health governance. It focuses on the problem of containing contagious diseases. This is one of the tasks of the World Health Organization (WHO) and its practice of declaring a Public Health Emergency of International Concern (PHEIC). Given the uncertainty surrounding such a practice, which could lead to the isolation of an effected state, the decision inevitably involves judgement calls rather than the pre-reflexive implementation of pre-planned steps. Applying the first Pragmatic Constructivist test to this practice means asking if the community of practice charged with making that judgement is properly constituted and sufficiently inclusive. The evidence suggests that it is not. The chapter problematizes practice that unduly privileges technical (in this case epidemiological) expertise over social and political advice. A second application of the two Pragmatic Constructivist tests focuses on an inconsistency internal to global health practices as they relate to the distribution of vaccines. Practices that achieve more comprehensive coverage, such as the local manufacture of vaccines, are being prevented by intellectual property practices. The chapter considers how the knowledge of the Covid pandemic challenges the epistemic authority of intellectual property practices.