US billionaire Bill Gates and OpenAI are placing a sizable wager on artificial intelligence (AI) as a lever to strengthen Africa’s overstretched primary healthcare systems, committing US$50 million to a multi-year initiative aimed at deploying AI tools across 1,000 clinics by 2028.
- •The project, dubbed ‘Horizon 1000’, brings together the Gates Foundation’s long-standing focus on global health delivery with OpenAI’s expanding ambitions beyond research and consumer products.
- •The initiative will begin in Rwanda and is designed as a pilot for broader adoption across the continent, where shortages of trained health workers and uneven care quality continue to undermine health outcomes.
- •While AI systems have grown more powerful, their deployment in frontline healthcare has lagged, constrained by infrastructure challenges, regulatory uncertainty, and the complexity of medical decision-making.
“I’m looking forward to seeing health workers using some of these AI solutions in action when I visit Africa, and I plan to continue focusing on ways AI technology can help billions of people in low- and middle-income countries meet their most important needs,” Bill Gates said.
Under Horizon 1000, AI tools are expected to assist frontline health workers in navigating clinical guidelines, managing administrative tasks, and supporting diagnostic and treatment decisions. The goal is to reduce time spent on paperwork and protocol interpretation, allowing clinicians to focus more on patient care.
The program also reflects growing demand from patients themselves, many of whom are already turning to digital tools to understand symptoms, treatments, and care pathways.
For OpenAI, the initiative marks another step in translating rapidly advancing AI capabilities into practical applications in low-resource settings.
“AI is going to be a scientific marvel no matter what, but for it to be a societal marvel, we’ve got to figure out ways that we use this incredible technology to improve people’s lives,” said Sam Altman, CEO of OpenAI.
The Gates Foundation has for years focused on health system strengthening rather than disease-specific interventions alone. Horizon 1000 reflects a belief that if AI is embedded into everyday clinical workflows, it can help close gaps in access and consistency without requiring a commensurate increase in personnel.
Primary healthcare remains out of reach for roughly half of the global population, with Sub-Saharan Africa bearing a disproportionate share of the burden. The region faces an estimated shortfall of more than five million health workers, leaving clinics understaffed and clinicians stretched thin. The result has been wide variation in care quality and high rates of preventable illness and death.
The Gates Foundation plans to dedicate US$200 billion over the next 20 years in Africa, focusing on partnerships with governments that prioritize primary healthcare systems, nutrition, and education as foundations for long-term prosperity. However, such acts of philanthropy have been smudged with controversy.
The foundation has been accused of wielding disproportionate influence over health and agriculture policy in developing countries and prioritizing Western-driven technical solutions over local needs.
