Nearly one quarter of the global disease burden can be attributed to the environment. Indoor air pollution, vector-borne disease, limited access to clean water and sanitation and poor land management are among the biggest killers, costing more than 100 million disability-adjusted life years every year. Changing climates are set to worsen the problem by 2030, an estimated 310 million people are expected to have suffered ill health from climate change. Nine out of ten of these people will be in developing countries. Improving environmental health raising its profile at national, state and local levels, and integrating environmental health issues into development plans and activities is critical if we are to reduce poverty and meet the Millennium Development Goals.