Five years down the road from Rio

The earth has not moved much

Five years ago in Rio de Janeiro the earth summit agreed on Agenda 21, a 40 chapter plan of action for achieving sustainable development. Progress has been poor, heads of state and environmental ministers heard at a special session of the general assembly of the United Nations last week,1 but it was not all bad news. Some promising developments have occurred in international policies and agreements. And we now know more about those aspects of global change with important implications for human health: global warming, the loss of biodiversity, and persistent organic pollutants.2 3 4 5

Global warming will probably bring extremes of weather, new infectious illnesses, threats to food production, flooding, forced migration, and a rise in sea level. Destruction of habitats and extinction of species result in the loss of materials for medical research and ecological services (such as water cleansing, pollination, and soil production) necessary for good health. Organic pollutants, particularly chlorinated hydrocarbons, may contribute to the rising incidence of reproductive disorders.

Since 1992, limited progress has been …