The urgent need to tackle obesity and prevent type 2 diabetes is now widely acknowledged, particularly by the health ministers worldwide who in May 2004 gave their unanimous approval to the World Health Organization (WHO) Global Strategy on Diet, Physical Activity and Health. Many health ministries around the world have policies to cope with these most pressing public health issues. But their detailed strategies are often unclear. Indeed, almost everywhere, national programmes to address obesity and diabetes are still under development. Most of the actions undertaken so far have involved small steps in policy terms, and limited initiatives, and largely have represented a response in developed countries to growing public pressure – due to rapid increases in childhood obesity. Neville Rigby reports on the need for governments to make a firm commitment to major long-term national strategies.