In 1983, after over 10 years of working on mathematics education reform in the Philippines, I wrote a paper for a Tokyo conference arguing that education reform in developing countries such as the Philippines should begin by working on macro-problems, namely the social, political, and economic environment of the schools, as a context for the micro-problems, the usual concerns of curriculum, teacher training, textbooks, and so forth. This article recounts how we carried out this approach to education reform in three large-scale initiatives: the Third Elementary Education Project (TEEP), the Synergeia Foundation, and the Ateneo Center for Educational Development. The TEEP is an education project for the 23 poorest provinces in the Philippines, which began in the mid-1990s and was carried out fully from 2000 to 2006. The Synergeia Foundation, Inc. and the Ateneo Center for Educational Development are organizations which have been working with elementary schools on the scale of whole towns, cities, and provinces. They are also now beginning their work with high schools. What these initiatives have in common is that they begin by engaging the community, the school superintendents and supervisors, principals, teachers, parents, and political and civic leaders. A process is followed to have them focus on the realities of their schools, develop consensus on strategic plans and priorities, and participate in the process of achieving goals. Implementation then focuses on what we call targeted interventions, such as teacher training, educational materials, and physical facilities, which address the agreed-on priorities. The evaluation of the Third Elementary Education Project (TEEP) at its end in 2006 shows that the approach leads to major improvement on a large scale. We are seeing the same kind of results in the work of Synergeia Foundation, Inc. and the Ateneo Center for Educational Development.