A primary focus of the IFPRI 2020 Vision initiative is to find ways for people to attain food security, that is, sufficient food to lead healthy and productive lives. But what is sufficient? And is providing access to food the primary means of protecting people (particularly women and children) against malnutrition, which now faces millions of people around the world? Recent evidence indicates that improvements in household food security, as measured by adequate calories, do not necessarily translate into improvements in the nutritional status of women and children. One reason for persistent malnutrition may lie in the complex interaction between food supply and illness, which is influenced by the overall health environment. This is often called the "leaking bucket effect" wherein improvements in access to the foods that are important for good nutritional status may be offset by poor access to nonfood inputs, such as quality health care facilities and services, education, sanitation, and clean water or ineffective mechanisms for delivering these services. If this is so, greater emphasis should be placed on improving access to these nonfood inputs in order to achieve the 2020 Vision. This brief examines these issues.