The sphere of international development assistance (IDA) is undergoing significant changes, primarily due to the economic rise of the countries of the Global South. At the same time, the importance of IDA as an area of interstate cooperation remains high, as evidenced by the priority attention to this area on the part of the UN and other influential international organisations. In this regard, from the standpoint of historical and sociological institutionalism, we have analysed the cause-and-effect relations that condition the current problems of IDA and proposed ways of solving these problems. Using the aforementioned theoretical approaches, the gap between the conceptual and practical development of international aid was identified, including how donors impose the development track and the concept of IDA itself on recipients. It is shown how, including as a result of “institutional layering” in the relevant organisations, the interaction between “new” and “traditional donors” is significantly impeded, and how the latter use historically developed structures to pursue their state interests against the background of objectively falling volumes of aid from their side to the countries in need. It was noted that in order to resolve the identified contradictions, it is necessary to start a discussion in the academic and professional community, based on inclusiveness and respect for cultural diversity, on the individual development trajectory for each society, the tasks of IDA and the forms of appropriate interaction in each case. It is important to encourage openness and independent criticism in order to objectively highlight the benefits to both recipients and donors of engaging in IDA activities. Efforts should continue to develop an integrated approach for more accurate and consistent monitoring that communicates results to the general public.