Having worked in the global health field, it has always concerned me that the emphasis of many in the field (and in the EA) community seems to be solely focused on second order interventions that bypass the state. Often it seems that the removal of particularly incompetent/abusive dictators would do much more in the long-run to improve healthcare outcomes than even the most well-suited targeted interventions. While the obvious pushback may be that regime change is difficult and there is no universal blueprint (nor guarantee that the next regime will be better), there does appear to be low hanging fruit on this front. For example, eSwatini's monarch has systematically hindered economic growth while receiving millions in healthcare aid despite rates of HIV and other communicable diseases remaining as high as anywhere in the region. Recent protests suggest that well-targeted aid could facilitate a democratic transition, but this doesn't seem to fit into any existing models of impact. Can anyone point me in the direction of any related work? Thanks in advance.