For many developing countries health assistance allocation is a paramount concern. Underlying issues are very important, including how agencies define need, determine eligibility, and decide what support to provide to whom. The governance of these processes is also crucial. The consequences of aid allocation decisions are enormous, and are felt most directly by billions of people living in low- and middle-income countries. This special issue of Health Policy and Planning on Global health aid allocation in the 21st century questions the rationale of the Gross National Income per capita (GNIpc) as a primary indicator of need and capacity. The authors think that there are now many reasons to revisit this practice. This issue includes five articles, focusing on how aid allocation works now, testing the correlation of GNI pc and health outcomes, exploring the normative basis for allocation through stakeholder preferences, analyzing how those preferences would change allocation rankings, and concluding with a model for calculating financing gaps to show where aid can make the most difference. Interesting arguments and food for thoughts and discussion?
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