Disease ecology at a crossroads: man-made environments, human rights and perpetual development utopias.

There is a growing body of critical literature on health, development and environmental sustainability in a world of finite resources and overburdened ecosystems. The ethics of progress and perpetual development in pursuit of unlimited economic growth and ever-expanding markets are no longer viable, given the constraints imposed on the life-support systems of the biosphere and a finite resource base, which poses the most serious threat to life on Earth. Despite increasing evidence of the linkages between economic growth and environmental deterioration and a rhetoric expressed in a growing body of laws, regulations, accords and global "agendas" at the national and international level, there are all too few success stories in reversing or even slowing down the current trends of ecosystem degradation and decreasing cultural and biological diversity. On the contrary, there is evidence that environmental stress and deterioration are increasing, and the impact on the mental, physical and social health and well-being of populations is more significant now than in any previous time in history. The fragmentation of countries, the rise of nationalism and ethnic conflict, the decimation of indigenous nations and human rights abuses are often closely interrelated with environmental degradation and development initiatives. This paper reviews some of the concepts and underlying values of the main "models" developed by health and social scientists for interpreting this reality, with the aim of stimulating debate that could lead to the adoption of a larger and more comprehensive framework for analysing the interactions between human health, development and environmental change.