This story is part of the 2025 Future Perfect 25

Every year, the Future Perfect team curates the undersung activists, organizers, and thinkers who are making the world a better place. This year’s honorees are all keeping progress on global health and development alive. Read more about the project here, and check out the other categories:

• On the Ground
• Innovators
• Movers and Shakers

Have ideas for who should be on next year’s list? Email us at futureperfect@vox.com.

The roots of the world’s most stubborn global health problems don’t yield to vibes-based solutions. They surrender to data, rigor, and the surprisingly radical idea of actually trying to figure out what works.

Governments and nonprofit organizations depend on the economists, activists, policymakers, and writers who are reshaping how we understand poverty, health, and progress. They’re the ones making sure that every dollar saves the maximum number of lives, that foreign aid is steered by evidence instead of dogma.

They’re also the ones who are open to trying something new, such as giving the simplest solutions — like a plate of beans or a clear-eyed approach to masculinity — the platform they deserve. Because when it comes to making the world better, good intentions are just the starting line. — Izzie Ramirez, deputy editor

Dean Karlan

When the Trump administration sicced its newly minted “Department of Government Efficiency” on the US Agency for International Development earlier this year, for just a moment, Dean Karlan offered to help.

After all, as USAID’s first chief economist, Karlan’s life’s work revolved around efficiency. His job was to help the agency stretch its dollars more effectively, save more lives, and propel US goals around the world. He has preached against waste, fraud, and abuse for longer than some of the DOGE bros have been alive.

“I’m not a political appointee,” he told me earlier this year. “I’m just a dorky wonk who was on detail and who cares about the evidence of impact.”

But it quickly became clear to Karlan that DOGE’s wrecking crew couldn’t care less about evaluating programs or prioritizing cost-effectiveness. His overtures to help went unanswered. Eventually, as he watched Elon Musk and Secretary of State Marco Rubio take a sledgehammer to relatively cheap, lifesaving initiatives like PEPFAR, as longstanding colleagues were sacked, and the agency denigrated as a “ball of worms” and a “criminal organization” that needs “

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