The reductionist, compartmentalized approach to science and problem-solving that has prevailed throughout the 20th century is proving inadequate to deal with the problems we face at the cusp of the Millennium. We need innovative, transdisciplinary approaches, new coalitions among biological, physical, behavioural and social scientists, and scholars from outside the range conventionally regarded as "science." Economists, politicians, representatives of management and labour, religious leaders, scholars from the humanities, ethics and philosophy, all have a role. One ingredient of successful adaptation to the challenges we face, especially from the threat of global change, is a change in human behaviour, that will have to be preceded by a change in values, or attitudes and beliefs.

There is a necessary sequence to control health problems: awareness that the problem exists, understanding what causes it, capability to control the cause, a sense of values that the problem is important or worth solving, and political will. I am encouraged by what I see around me to indicate that this sequence has begun to operate in responses to human-induced ecological determinants of disease.

We have a long way to go. But as Mao Tse Tung put it, our journey must begin with a single step. Let us take that step, towards a world that lives in greater ecological harmony than our world does today.

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