Like most of the world, China, India, and Chile—the three countries discussed in this volume—are all characterized by increasing inequity. Equity is not the primary goal driving core policies and programs, and equity is often knowingly and readily sacrificed for other goals. In such a context, is it reasonable to expect that interventions generated from systems that perpetuate and deepen inequities, and do not challenge those systems and outcomes, will lead to equity? Is it reasonable to expect further that evaluation of such interventions will enhance equity? This chapter suggests that it is reasonable, but only if such evaluations are understood and framed as intentional disruptions to systems perpetuating inequities. Taking India as an example, the chapter lays out the persistence of health inequities in India and discusses implications and possible solutions emerging from seeing program and other evaluations as an opportunity to disrupt program, organizational, or system ecologies that perpetuate inequities. The chapter sees no conflict between, and argues for, models of evaluation that are both rigorous and transformative.