In June 2012, Brazil hosted Rio+20, the United Nations Conference on Sustainable Development (UNCSD) marking the 20th anniversary of the 1992 Earth Summit. The Rio+20 outcome document entitled The future we want provides general guidance to shape sustainable development policies, but fell short of providing legally binding agreements or pragmatic goals. Negotiators agreed to develop a process for the establishment of new Sustainable Development Goals (SDGs), building upon the Millennium Development Goals, and setting the foundation for the post-2015 UN development agenda. Our objective is to argue that discussions beyond Rio+20 and toward the adoption of SDGs offer a critical opportunity to re-assess the major challenges for global health and sustainable development. There is an urgent need to translate the general aspirations put forth by Rio+20 into concrete health outcomes and greater health equity. The way toward the post-2015 SDGs will likely be more effective if it highlights the full gamut of linkages between ecosystem processes, anthropogenic environmental changes (climate change, biodiversity loss, and land use), socio-economic changes, and global health. Negotiations beyond Rio+20 should strongly acknowledge the global health benefits of biodiversity protection and climate change mitigation and adaptation strategies, which reduce diseases of poverty and protect the health of the most vulnerable. We argue that health and ecosystems are inextricably linked to all development sectors and that health should remain a critical priority for the upcoming SDGs in the context of global environmental change.