Abstract
This paper discusses the many reasons why environmental health is given too low a priority by governments in Africa, Asia and Latin America, and why limited resources are often used ineffectively. It illustrates this with a case study of the ineffectiveness of government action to control cholera in Madagascar and of the political reasons why the government was unwilling to work with the international agency, Médecins sans Frontières. The paper concludes with a discussion of the institutional, political and economic, technical and socio-cultural hindrances to effective government action and of the research agenda needed to help ensure more effective environmental health.