Apple has introduced PayPal support as a way to make purchases within its ecosystem, meaning it’s going to get easier to trick iTunes into thinking you’re in another country if you want access to different apps.
PayPal hides your credit card information, meaning you could technically trick the App Store into thinking you’re in another country and access another country’s suite of apps.
Previously, you needed a US credit card to pay for apps on the US store.
You could already create an Apple ID in any country you wanted without a credit card for free downloads, but you had to buy gift cards first to access paid apps.