Some things are just timeless: as relevant as when they first came out. Some great examples of this include George Orwell's 1984, the stand-up acts of Bill Hicks or George Carlin, and this cover for Nirvana's second studio album, Nevermind.
The balance and art direction are great, but I think at the end of the day, for a design to have a great amount of impact and staying power it needs to have a great message. The message here is quite clear; it is an image of humankind, and how we're distracted and lured in by material goals to the exclusion of the important things in life. I don't think this issue will ever cease to be relevant, unless we all wake up one day to find that worldwide corporations have stopped polluting and exploiting and making wars for profit, and have instead decided to focus on feeding the hungry.
...Or something like that. It's a timeless and thought-provoking message, which is why Nirvana is as popular with angsty teenagers today as it ever was.