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The principles of equality and equity, respectively in the Bill of Rights and the white paper on health, provide the moral and legalfoundations forfuture health care for children in South Africa. However, given extreme health care need and scarce resources, the government faces formidable obstacles if it hopes to achieve a just allocation ofpublic health care resources, especially among children in need of highly specialised health care. In this regard, there is a dearth of moral analysis which is practically useful in the South African situation. We offer a set of moral considerations to guide the macro-allocation of highly specialised public health care services among South Africa's children. We also mention moral considerations which should inform micro-allocation. (J7ournal ofMedical Ethics 1999;25:224-229)

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