It's not clear that Google are taking this tack, but, as with content, I feel it's time to introduce the concept to the Web.
Author and publisher accountability.
Advertising providers, and advertising publishers, who forward "bad ads" are given a time-out.
Perhaps 10 minutes for the first instance, but increasing durations for repeat ocurrences. Days, weeks, and months for gratuitious violations.
Ad providers and publishers who find they're being timed out for violating standards are, likely, going to clean up their acts, and find ways to ensure that mistakes don't happen. Including direct vetting of content -- on their own if not by Google.
This is in Google's interest, because, as with others on this thread, the way I fought bad ads in 2015 was to install 60,000 lines plus of /etc/hosts entries, uBlock origin, Ghostery, Privacy Badger, uMatrix, and, for added pleasure, Styleish, to rewrite site CSS myself. On all my own platforms.
And across the desktops of users I administer for.
Virtually all advertising is worthless, targeted advertising doubly so, and Google are in for hurt if they cannot reverse this perception. Meantime they're best positioned to buy themselves a few more years of time.
The other end they could try fixing is to make the results of directed product search -- that activity that happens when people are actively seeking products or services -- not suck as abysmally bad as it does now. Boot camp for vendors of how you should, and shouldn't, write ad copy, take product images, etc., might not be out of the question. Not that Google's to blame for all of this (not in the least) -- Amazon's product search pages are as bad as any I've seen online (Ikea, by contrast, does well, the moreso because they showed me what I wanted to look for at the store).
Or maybe it's time for a true Federated Retail initiative.