In 2023-4 the Australian Bureau of Statistics reported that 34% of lone parent households and 16% of family households with dependent children in Australia experienced food insecurity. Childhood experiences of food insecurity can impact growth and development and have lifelong consequences for health. Improving the food security of people living in rural and remote communities is both a public health priority and a poisoned chalice for Australian Governments. Many of the actions that are needed to address the determinants lay outside of the health sector. Food security in remote Indigenous communities is particularly challenging resulting in a disproportionate burden from preventable diet-related diseases in these communities. Improved food security will result in health gains. Interventions aim to achieve a secure, sustainable, safe, nutritious and culturally appropriate food supply in these communities and changes to dietary patterns a major outcome. Public health action must address supply and demand, and infrastructure to create environments to support change. Public health needs to advocate for suitable and effective interventions. Gleaning insights from the last three decades, this presentation explores a range of actions that are the most effective in the real world – from cross sector regulatory instruments to health ‘education’ in a clinical setting. Sustained action across all sectors and governments are required to address the structural and systemic problems that have resulted in poor food security for many communities.