As large language models are increasingly deployed in sensitive domains such as healthcare, ensuring their outputs reflect the diverse values and perspectives held across populations is critical. However, existing alignment approaches, including pluralistic paradigms like Modular Pluralism, often fall short in the health domain, where personal, cultural, and situational factors shape pluralism. Motivated by the aforementioned healthcare challenges, we propose a first lightweight, generalizable, pluralistic alignment approach, ETHOSAGENTS, designed to simulate diverse perspectives and values. We empirically show that it advances the pluralistic alignment for all three modes across seven varying-sized open and closed models. Our findings reveal that health-related pluralism demands adaptable and normatively aware approaches, offering insights into how these models can better respect diversity in other high-stakes domains.

Both image-caption pairs and translation pairs provide the means to learn deep representations of and connections between languages. We use both types of pairs in MURAL (MUltimodal, MUltitask Representations Across Languages), a dual encoder that solves two tasks: 1) image-text matching and 2) translation pair matching. By incorporating billions of translation pairs, MURAL extends ALIGN (Jia et al.)–a state-of-the-art dual encoder learned from 1.8 billion noisy image-text pairs. When using the same encoders, MURAL’s performance matches or exceeds ALIGN’s cross-modal retrieval performance on well-resourced languages across several datasets. More importantly, it considerably improves performance on under-resourced languages, showing that text-text learning can overcome a paucity of image-caption examples for these languages. On the Wikipedia Image-Text dataset, for example, MURAL-base improves zero-shot mean recall by 8.1% on average for eight under-resourced languages and by 6.8% on average when fine-tuning. We additionally show that MURAL’s text representations cluster not only with respect to genealogical connections but also based on areal linguistics, such as the Balkan Sprachbund.