The tale that world leaders and environmentalists will try to tell at this week’s summit in Johannesburg is much less riveting. As storytellers, they have the added burden of experience. Although the past few decades have brought some environmental successes–improvements in outdoor air quality, for instance–new problems seem to arise faster and faster. Forests and fish are disappearing at an alarming rate, formerly livable areas are turning into deserts, the list of endangered and extinct species grows each year and rising temperatures are melting glaciers and shifting rainfall patterns. At the same time, there’s been a growing consensus that no fix is going to work for long unless it takes into account the lives of the people who live on planet Earth–particularly the poorest among us. People cut forests because they need the wood; they fish because they need to eat (or else they sell their fishing rights because they need the money). Without a strategy that addresses people’s behavior, the most well-intended policies won’t work, and might even make things worse. DDT, for instance, may be a truly horrible chemical, but without it there’s been no sustained effort to contain the mosquitoes that spread disease. Malaria kills 1 million people each year, and it’s on the rise.

Thus the call for “sustainable development.” As a catchphrase, it doesn’t have much oomph. It tends to

mean different things to different people. Unlike other environmental causes, it doesn’t flag a problem or even really suggest a solution. It’s a guiding principle: what Earth needs is for people to find new ways of making their living without running the environment into the ground. The big insight that the sustainable-development advocates bring to environmentalism is the notion that small projects initiated largely at the community level may be more important than the big, glamorous causes. “It took us 30 years to come to the painful conclusion that we need to take into account local life,” says Bill Clark, a sustainability expert at Harvard.

Is this message too nuanced? The 1992 summit in Rio de Janeiro was supposed to have been devoted to a range of sustainability issues, but the drumbeat of climate change wound up drowning out the others. Profligate burning of fossil fuels, which releases carbon into the atmosphere, is a classically unsustainable practice. But doomsday climate scenarios are far easier to fashion into a cause than to solve. (For instance, environmentalists never managed to convince China and India of the dire need to cut back on carbon emissions.) And is global warming really the highest priority? “The Rio conference was supposed to be about sustainable development. It was turned into a climate-change conference,” says Clark. “The great tragedy is that we should have been looking at the areas of environmental degradation from human activities that really kill people.” The truly urgent issues tend to be both complicated and mundane.

Consider the decidedly unglamorous problem of indoor air pollution. You wouldn’t know it from reading the headlines, but it’s the world’s No. 1 human health problem, according to mortality statistics. In developing countries, hundreds of millions of people burn wood, agricultural scraps and animal dung in their homes to keep warm and cook their food. In India, such “biomass” accounts for 40 percent of energy consumption. Soot in the smoke, when breathed in confined spaces, is deadly. Indoor air pollution kills 3 million or 4 million people each year, says energy expert Dan Kammen at the University of California, Berkeley. “Respiratory illnesses account for 10 percent of global deaths,” he says.

In a recent study in rural villages in Kenya, Kammen replaced old, inefficient stoves with clean-burning ones (at the cost of $1 apiece). Deaths from respiratory illness were cut in half. NGOs have distributed 150 million of the new and improved stoves to China, 8 million to India and 2.5 million to Kenya. The best long-term solution, says Kammen, would be to introduce windmills and solar panels, but there’s little support for bringing clean energy to developing countries. The obstacle, says energy expert John Holdren at Harvard, is the status quo. “There’s a $10 trillion investment in the current energy system, fossil fuels,” he says.

The No. 2 global killer is contaminated drinking water, says Peter Gleick, director of the Pacific Institute for Studies in Development, Environment and Security. “The greatest development failure of the 20th century was the failure to provide clean drinking water and sanitation services to all the Earth’s people,” he says. More than a billion people are without access to clean water, and 2.4 billion lack sanitation services. Cholera, dysentery and other parasites kill more than 3 million people a year. Between now and 2020, Gleick predicts, more than 76 million people will die of these diseases–more than will have died from AIDS. Past efforts to correct the problem have been misguided, he says. “They focused entirely on building large centralized infrastructures that are very expensive: big dams, big reservoirs, big aqueducts and centralized waste-treatment plants.” What’s needed are small projects at the community level. “It’s easier to build a billion-dollar dam than to deal with 1,000 million-dollar systems,” he says.

Even air pollution, one of the first problems environmentalists grappled with, has been handled badly. Although local prevention programs have improved air quality in cities like Los Angeles, it’s drastically worsened in many developing cities. Scientists in developed countries have also overlooked regional interactions among different sources of air pollution, which interact to create huge swaths of smog in the southeastern United States and parts of China. Rural air fills up with emissions from agricultural products, like fertilizer, and then mixes with smokestack and combustion-engine emissions. “What we used to view as urban air pollution, the problem of the individual city, has expanded. We’ve begun to see regionwide tides of smog,” says Pamela Matson, an ecologist at Stanford. “We’re struggling to learn how to deal with air pollution at the regional and continental scale.”

Where scientists have come up with solutions, they’ve done less well in transferring their innovations to the developing world. The main problem is that they haven’t taken into account local needs and preferences. The development of “miracle rice” and other grains is a case in point. The idea was to breed rice selectively to respond more efficiently to fertilizers and irrigation, making it better suited to growing conditions in the developing world. But the rice didn’t cooperate. “It turned out that rice developed in Philippine field stations wasn’t right for uplands rice in Thailand or south-slope rice in Indonesia,” says Harvard’s Clark. Technical breakthroughs just aren’t enough. Local labs have to adapt the rice to local conditions, and they need the expertise of national labs and universities. Most developing countries don’t have this expertise. Where will they find the money to get it?

That’s what leaders at Johannesburg are trying to figure out. So far, efforts have been modest. The United Nations has had some success with small pilot projects, but nothing’s been tackled on a large scale. Last March in Mexico, some U.N. member states promised $30 billion for programs in sustainable development over the next four years. The European Community pledges to kick in $50 billion more in foreign aid per year to developing countries. This time around, these nations say, the approach will be attuned to local needs. Scientists are also trying to bring a broad cross section of disciplines to bear on the most intractable problems. How can energy needs in the developing world be met without cutting down forests? How can we avoid the kind of “multiple intersecting environmental stressors” that are turning the Aral Sea into a desert?

After 40 years, the environmental movement has achieved little in the way of results. Johannesburg is not likely to be any different. “If we’re lucky, governments will be put on the spot for not having delivered before the conference and, in effect, be pushed to make things happen after the conference that can be monitored, funded and then enforced,” says J. Gustav Speth, former head of the United Nations Development Program and now at Yale. “Our best hope is that there will be a mild panic.” Noble causes and lofty sentiments simply aren’t making it. What we need now are modest solutions that work.