I've found that it's gone spastic, maxing out the budget every day. The automatic content placement is placing the ads on ridiculous sites, e.g. video game and random anime sites, which are totally out-of-context and unrelated to any of our keywords (which relate to a niche product concerning a fairly niche sports industry).
My older campaigns target "All languages", which isn't an option on new ones, so this time I'm just targeting Spanish and Portuguese in addition to English.
Ads, keywords, and the landing page are all English only. From the way I understand Google targets languages, I think it is too restrictive to target only English in this region and don't want to do this.
I haven't had this problems in any other campaigns, including Europe, with countries speaking Dutch, German, Italian, and Nordic languages, so I am doubtful that it's a language issue in any case. Anyway, the keywords are English, so shouldn't that mean that automatic placements basically skip Spanish websites?!
[I know from stats that these worthless clicks are 1) from Spanish speaking countries, 2) are Spanish speaking (clients registered as "es" in Analytics), and 3) are coming from Spanish language websites.]
So I don't get the total failure of the content placements. For the time being I've given up adding exclusions, and have just turned automatic placement off.
Any ideas?