I don't understand your "delusional, self serving, narcissistic and ineffective" / "egotistical" point. All of this would apply to people trying to change things from the outside too.

Who the hell do you think you are in the great machine of hundreds of millions of US citizens, or billions of people globally, to think you can effect political and regulatory change?

And yet, this is how things change, by people working to change them, from either the inside or the outside. Maybe your point is right that anyone trying to be a change agent is self serving and egotistical. But don't fool yourself that there is some big difference here between internal and external activists.