Gates Foundation & OpenAI Launch $50 Mn Horizon1000 to Scale AI in African Primary Health Care

The initiative is designed to equip up to 1,000 clinics with AI-enabled tools that can support frontline health workers, improve care quality, and help health systems cope with widening gaps in financing and staffing.

The Gates Foundation and OpenAI have announced a $50 mn initiative, Horizon1000, to deploy artificial intelligence across primary health care systems in Africa, beginning with Rwanda, by 2028.

The initiative is designed to equip up to 1,000 clinics with AI-enabled tools that can support frontline health workers, improve care quality, and help health systems cope with widening gaps in financing and staffing.

The partnership comes at a time when many low- and middle-income countries are facing sharp reductions in external health financing. Global development assistance for health fell by nearly 27% last year compared with 2024, according to estimates cited by the Gates Foundation.

These declines followed decisions by major donors, led by the United States in early 2025, to pause or cut foreign assistance, disrupting programs that support HIV treatment, maternal and child health, nutrition, and essential primary care services.

Rwanda has been selected as the starting point for Horizon1000, reflecting its long-standing investments in digital health and national data systems. The country has already established an AI health hub in Kigali and expanded internet access to most of its population, creating a foundation for scaling AI-enabled health services.

“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,” said Paula Ingabire, Rwanda’s minister of information and communications technology and innovation.

Bill Gates has positioned AI as a practical response to severe health workforce shortages across sub-Saharan Africa, where some countries have only one doctor for tens of thousands of people. He said AI tools could help streamline administrative work, support clinical decision-making, and provide guidance to patients even before they reach a clinic, particularly where language barriers exist.

“Using innovation, using AI, I think we can get back on track,” Gates said, referring to the setback caused by aid cuts and rising preventable child deaths.

Under Horizon1000, AI applications are expected to focus on areas such as maternal health, HIV care, disease triage, scheduling, and linking patient histories across visits. By reducing paperwork and improving information flow, Gates said, clinic visits could become significantly faster while maintaining higher standards of care. “A typical visit, we think, can be about twice as fast and much better quality,” he said.

By working with governments, health workers, and local innovators, the Gates Foundation and OpenAI say the initiative could serve as a model for how AI can strengthen primary health care in resource-constrained settings, even as traditional sources of global health funding remain under pressure.

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