Global health and national borders: the ethics of foreign aid in a time of financial crisis

We undertook a critical review of contemporary accounts of justice. We selected theories that: (i) articulate important and widely held moral intuitions; (ii) have had extensive impact on debates about global justice; (iii) represent diverse approaches to moral reasoning; and (iv) present distinct stances on the normative importance of national borders. Due to space limitations we limit the discussion to four frameworks.Consequentialist, relational, human rights, and social contract approaches were considered. Responsibilities to provide international assistance were seen as significant by all four theories and place limits on the scope of acceptable national autonomy. Among the range of potential aid foci, interventions for health enjoyed consistent prominence. The four theories concur that there are important ethical responsibilities to support initiatives to improve the health of the worst off worldwide, but offer different rationales for intervention and suggest different implicit limits on responsibilities.Despite significant theoretical disagreements, four influential accounts of justice offer important reasons to support many current initiatives to promote global health. Ethical argumentation can complement pragmatic reasons to support global health interventions and provide an important foundation to strengthen collective action.In keeping with the vision of “a more peaceful, prosperous and just world” enshrined in the United Nations Millennium Development Goals (MDGs) [1], initiatives to improve global health and human development have proliferated over the last decade [2-5]. Although developing countries play the leading role, the success of these strategies depends critically on the participation of the citizens and governments of the donor nations (principally, the state members of the Group of Eight Countries (G8) and the European Union) through financial assistance and supportive policies. International development assistance for health (DAH) has enjoy