I certainly don’t currently have fool-proof answer, but I think it would be a combination of economic incentives (ad consumers who perform better are paid more, worse are paid less). Of course the subject of what does “perform” mean and how do we measure it is open for question.
When you start thinking it through, the only way forward is more and more tracking - 'performance', 'are you human', 'show me your passport', etc. There doesn't seem to be any other way.
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