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Inequality is a key political issue of our times. It has political consequences, fuelling conflict and raising legitimacy challenges for regimes around the world, in democratic and non‑demo‑ cratic settings alike. At the centre of these challenges is the question of accountability: who can be held accountable, on what basis, how and by whom for tackling or failing to tackle which inequalities. In the field of global health, inequality has long been a key issue. A significant body of work — in global health and health systems research — has approached the issue of health inequalities and in‑ equities by highlighting the role of social determinants. A more recent and less developed stream of work frames them in terms of political determinants: in other words, seeing them as issues that may be addressed through politics as well as policy. As a contribution to this literature, and building on the decade-old consensus around the importance of political will in the expansion of access to health services, this Novos Estudos dossier focuses on the politics of ensuring accountability for health equity - or for reducing health inequalities.