Most of the world's population lives in third and second world countries. You're absolutely right that the centralized fiat gateways are the obvious, censurable bottlenecks of crypto-currency, and there's no good way around that, but crypto-currency itself is still an attractive way for many people, to move their money out of very restrictive regimes. The centralized exchange problem is mainly a problem of creating a black/grey market economy, with crypto-currency as it's main unit of value transfer, which of course is a whole other can of worms.