Many developing countries are undergoing rapid socio-economic changes that impact on health and its social distribution. These changes can occur so rapidly that there is a resulting co-existence of diseases of affluence and diseases of poverty. Priority setting for nutritional programmes has focused on the alleviation of undernutrition in low income settings. However, evidence shows that in many Low-and-Middle Income Countries the prevalence of obesity among women is increasing and can coexist with childhood stunting. This dual burden of poor nutrition contributes to worsening health inequity between the poor and the rich. Global and national policy makers are looking for novel programs to replace social protection mechanisms deemed inefficient. Conditional Cash Transfer (CCT) programs have emerged as an increasingly popular poverty alleviation strategy with some positive results. However, there is evidence they may have a negative impact if the complexity of transition settings is not taken into account. In this paper, presented to the IUSSP Scientific Panel On Health Equity, 29 October 2009, we review the nutritional situation in Egypt and compare two CCT programs (Mexico and Colombia) in an attempt to identify features that would address both child undernutrition and adult overnutrition. We conclude with suggestions for design of an Egyptian CCT program that would help maximise benefit to its beneficiaries.