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Plant health is a key condition for a sustainable land use and rural economy. Drawing on a Rural Economy and Land Use (RELU)-funded project on the growing risk of plant diseases in the UK, current and future challenges to plant health are discussed. It is well recognized that farmers have an important role in shaping plant health policies at a time of major structural changes in agricultural industries. However, the role of consumers has also much potential to improve sustainability of plant disease management options. The phytosanitary legislation is catching up with the many recent developments in plant health, but needs to be integrated with policies aimed at achieving animal and human health. Interdisciplinary approaches in research on plant health, as well as an increasing involvement of stakeholders in the management of plant epidemics, are to be welcomed. Plant diseases also influence (and are influenced by) land use and environmental regulations in general. Climate change is likely to increase the frequency and magnitude of new plant disease outbreaks, particularly when combined with globalization of trade, intensification of land use and structural evolution of the agricultural sector. To tackle the many challenges to plant health, it is mandatory to ensure long-term funding for interdisciplinary plant health research and management.