Five years down the road from Rio. The earth has not moved much [editorial]

In 1992 in Rio de Janeiro the earth summit accepted Agenda 21 a plan of action for achieving sustainable development. Since then progress has been sluggish but more knowledge has surfaced about global warming the loss of biodiversity and persistent organic pollutants. Global warming is likely to produce extremes of weather new infectious diseases forced migration and a rise in sea level. Destruction of habitat will result in the loss of materials for medical research and ecological services while organic pollutants especially chlorinated hydrocarbons may contribute to the increase of reproductive disorders. In December 1997 in Kyoto a meeting will be held to agree on quantitative reductions for emissions of greenhouse gases. The biodiversity convention is stalled but progress has been made on the convention on international trade in endangered species and on policies on water forests and fisheries. The identification of medical wastes as an important source of toxic pollution and the discovery of endocrine disruption have drawn attention to health risks of organic pollutants. Persistent organic pollutants may be associated with the global fall in sperm counts; and the children of women who have eaten food contaminated with polychlorinated biphenyls have impaired intelligence and nervous system function. It is crucial to use good waste management in hospitals to reduce the amount of endocrine disrupting agents. In the past 5 years a series of conferences and publications by leading scientific organizations have focused on the health consequences of climate change and the World Health Organization issued a major new report on health and the environment. However in the US President Clinton refused to commit the country to reduce emissions of greenhouse gases unlike European leaders who follow environmentally sound energy policies.