[Environment and health: great concerns and fragile hopes]

In the world, 24% of the burden of disease is attributable to environmental exposures: this proportion is up to 36% for 0-14 year old children. This notable impact on health is due partly to old environmental problems: 2.6 billion people, more than 40% of the world population, do not have access to proper sanitation; about 1.1 billion people, mostly living in rural areas (84%), do not have access to sources of safe drinking water; 1,8 million people per year die of diarrhea out of which 1.6 million are children under 5. At the same time, in the developed world and in countries with economies in rapid transition, there is wide concern and growing scientific evidence on the effects of chemical environmental pollution and of climate change on health. In order to tackle effectively these issues, public health policies, addressing traditional problems with well known approaches as well as multisectoral strategies involving the society at large, are necessary.