If sustainable development is to mean anything, people must be healthy enough to benefit from it and not have their lives cut off prematurely. Development without health is meaningless. But the processes which are likely to occur in a world undergoing globalisation, climate change, urbanisation, population increase and many other changes, will impact upon human health in complex ways. Some of them will benefit us, others will create new or augmented threats to survival and health, while many others will have a complex mixture of effects.