Are democracies better than authoritarian regimes at managing crises posed by disease and disaster? Chapter 10 explores whether there is an authoritarian advantage and investigates how regimes react to these crises. To do so, the chapter first defines what we mean by democracies and authoritarian regimes. The chapter then explains what disadvantages and advantages authoritarian regimes have in managing diseases and discusses the studies that have demonstrated that democracies perform better on most health outcomes. This chapter also explores how populist leaders have responded to these crises compared to technocratic counterparts. To do so the chapter conceptualizes populist authoritarianism. Though populist leadership often rises in the wake of a crisis either by imagining a crisis or overexaggerating one, once in power, populists do the opposite. They downplay the dangers and may be slower to act. But can any generalizations be made about their record in managing diseases and disasters?