> As the Gates Foundation MO and your dad's experience probably shows, lasting change comes down to political will

Lasting change comes down to data-driven programs that work and the money to implement them. As long as you’re not asking for money and meet the community you’re working with where they are,[1] politics is mostly a red herring. My dad worked on projects that achieved incredible results in Bangladesh, for example, even though the government of the country was a complete clusterfuck the entire time.

> socioeconomic and racial factors, so solving that would require "solving" poverty and racism.

The way to eat an elephant is one bite at a time. There may be overarching “factors” that contribute to a result, but there’s usually an immediate cause of a problem that you can tackle directly with an effective program.

Mississippi, for example, is now #3 in the country for NAEP 4th grade reading and math scores for black students. It’s #1 for reading and #2 for math for Hispanic students: https://mdek12.org/wp-content/uploads/sites/59/2025/01/NAEPR.... Mississippi didn’t “solve poverty and racism.” It implemented a program that identified the immediate cause of certain problems and fixed them.

[1] Effective programs avoid creating political problems. When my dad was designing maternal health programs for Bangladeshi villagers, he met them where they were instead of where he thought they should be. For example, it turns out rural women wouldn’t use newly built clinics for giving birth because they didn’t trust “big city doctors.” So the program developed relationships with local midwives and traditional healers, who the women already trusted, and had them get training from the doctors and refer high risk pregnancies to the clinics while handling routine deliveries in the traditional way.