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The Gates Foundation and OpenAI have announced a $50 million initiative, Horizon1000, to harness artificial intelligence (AI) for strengthening primary health care across African countries, starting in Rwanda, according to Reuters.¹ The collaboration seeks to equip up to 1000 clinics with AI‑driven tools that support health workers, improve care delivery, and help counter the effects of declining international aid in regions with acute health workforce shortages.

“It is about using AI responsibly to reduce the burden on health care workers, to improve the quality of care, and to reach more patients,” Paula Ingabire, Rwanda’s minister of information and communications technology and innovation, said in a video statement released on Wednesday.

Horizon1000 seeks to address the growing challenges faced by African health systems, including declining international aid and shortages of trained medical staff. By integrating AI into primary care workflows, the initiative aims to enhance clinical decision-making, streamline operations, and improve outcomes for patients in underserved regions.

Last year, the Trump administration’s decision to pause US foreign development assistance for 90 days pending a policy review triggered widespread concern among humanitarian and development experts, as it effectively halted the flow of funds that support health, food security, education, and civil society programs in dozens of countries, according to Reuters.² Critics warned that this abrupt suspension, which applies to most United States Agency for International Development and State Department foreign aid programs unless specifically exempted, forced organizations to suspend operations, disrupted services like HIV treatment and nutritional support, and left millions of vulnerable people without critical assistance.

Human rights groups argued that the sudden cuts create a life‑threatening vacuum in essential services that other donors cannot immediately fill, undermining US global health and development leadership.

Using AI will help get back on track after global development assistance for health fell by just under 27% last year, compared with 2024, Gates told Reuters.¹

The collaboration underscores the potential for technology-driven solutions to strengthen health systems in low-resource settings. OpenAI and the Gates Foundation envision that these efforts could serve as a model for scalable, AI-supported health care interventions across the continent.

AI has significant potential to transform health care in Africa by supporting the achievement of the United Nations’ Sustainable Development Goal 3, which aims to ensure healthy lives and well-being for all, according to one study.³ Although AI has been applied in medical settings globally since the 1970s, its adoption in Africa has largely been limited to pilot projects addressing maternal and child health, infectious diseases, and non-communicable conditions.

“We recommend the acceleration of the ongoing improvement in Africa’s infrastructure, especially electricity and Internet penetration,” wrote the researchers of the study. “Reliable power supply and affordable Internet services will catalyze data generation and analysis needed for advanced automation of processes involved in patient care. Widespread use of electronic medical records and large medical databases will foster machine learning that is programmable for Africa.”

Key challenges include limited clinical data, inadequate digital infrastructure, high costs, legal and policy gaps, and risks of algorithmic bias. Despite these barriers, AI applications—from disease diagnosis and drug authentication to health worker scheduling and telehealth—show promise in improving care quality, efficiency, and access.

Accelerating infrastructure development, expanding local AI expertise, leveraging smartphones, and implementing supportive policies are critical steps for scaling AI in African health care systems.

“A major lesson from the experience of AI professionals working in resource-poor settings is that AI implementation should focus on building intelligence into existing systems and institutions rather than attempting to start from scratch or hoping to replace existing systems,” wrote the researchers. “African countries must also enact laws and policies that will guide the application of this technology to health care and protect the users.”

References

1. Rigby J. Gates and OpenAI team up for AI health push in African countries. Reuters. January 21, 2026. Accessed January 21, 2026. https://www.reuters.com/business/healthcare-pharmaceuticals/gates-openai-team-up-ai-health-push-african-countries-2026-01-21/

2. Trump pauses US foreign aid for 90 days pending review. Reuters. January 20, 2025. Accessed January 21, 2026. https://www.reuters.com/world/us/trump-pauses-us-foreign-aid-90-days-pending-review-2025-01-21/

3. Owoyemi A, Owoyemi J, Osiyemi A, Boyd A. Artificial intelligence for healthcare in Africa. Front Digit Health. 2020;2:6. doi:10.3389/fdgth.2020.00006