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Environmental harms have time horizons that differ across environmental policy arenas. Pollutant exposure typically involve slow moving, steady tempo events with long duration, and often become part of the everyday landscape. When and how do people mobilize around slow-moving harms? Based on extensive field research including 180 interviews, this paper analyzes variant levels of slow harms mobilization in three contaminated rivers basins: Buenos Aires, Argentina (high); Bogota, Colombia (moderate); Lima, Peru (weak). I argue that the presence of local activism and “principled” policy entrepreneurs can lead to slow harms policy change. Policy entrepreneurs—both inside the state and in society—were most successful in achieving slow harms policy change when they were aligned with prior human rights movements that had successfully worked to end state sponsored political violence. My findings suggest that historical legacies of pre-existing movements may matter most for changing environmental concern in weak institutional settings.