The provision of plant health has public good attributes when nobody can be excluded from enjoying its benefits and individual benefits do not reduce the ability of others to also benefit. These attributes increase risk of free-riding on plant health services provided by others, giving rise to a collective action problem when trying to ensure plant health in a region threatened by an emerging plant disease. This problem has traditionally been addressed by government intervention, but top-down approaches to plant health are often insufficient and are increasingly combined with bottom-up approaches that promote self-organization by affected individuals. The challenge is how to design plant health institutions that effectively deal with the spatial and temporal dynamics of plant diseases, while staying aligned with the preferences, values and needs of affected societies. Here, we illustrate how Ostrom’s design principles for collective action can be used to guide the incorporation of bottom-up approaches to plant health governance in order to improve institutional fit. Using the ongoing epidemic of huanglongbing (HLB) as a case study, we examine existing institutions designed to ensure citrus health under HLB in Brazil, Mexico, the United States and Argentina, and discuss potential implications of Ostrom’s design principles for the collective provision of plant health under HLB and other plant diseases that are threatening food security worldwide. The discussion leads to an outline for the interdisciplinary research agenda that would be needed to establish the link between institutional approaches and plant health outcomes in the context of global food security.