The Gates Foundation and U.S.-based artificial intelligence firm OpenAI have pledged US$50 million to deploy AI-driven solutions across 1,000 health centers in Africa by 2028, aiming to strengthen primary care and ease pressure on overburdened frontline staff.
The “Horizon 1000” programme will begin with a pilot in Rwanda before expanding to other sub-Saharan countries, the organisations announced on January 20. The initiative seeks to move African health systems beyond experimentation, demonstrating how AI can support clinical decision-making, reduce administrative workloads, and enable health workers to spend more time with patients.
“AI will inevitably be a scientific marvel, but to make it a societal marvel, we must find ways to use this extraordinary technology to improve people’s lives,” said OpenAI CEO Sam Altman.
Addressing a critical shortage of health workers
Sub-Saharan Africa faces a severe shortage of healthcare professionals, with an estimated 5.6 million positions unfilled. The deficit contributes to uneven service delivery and preventable deaths, particularly in rural and underserved areas. Primary care, the cornerstone of resilient health systems, remains out of reach for nearly half of the continent’s population.
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The Gates Foundation and OpenAI said AI technologies could help bridge this gap by assisting clinicians with complex protocols, automating routine administrative tasks, and facilitating self-monitoring tools for patients.
Several African nations have already begun integrating digital health tools into their national systems. According to the Montreal International AI Expertise Center (CEIMIA), AI is increasingly being used in telemedicine, operational management, diagnostics, medical imaging, data-driven monitoring, and drug discovery. Telemedicine and remote patient monitoring account for nearly one-third of AI applications in the region, connecting patients with health professionals through video, messaging platforms, and virtual consultations.
Infrastructure and data challenges
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Despite progress, significant barriers remain. Most AI funding and research hubs are concentrated in anglophone countries, leaving francophone and rural regions underserved. Private companies and universities receive the majority of investment, while governments and civil society play a limited role.
Infrastructure gaps also pose obstacles. Many rural health centers face unreliable electricity and limited internet connectivity. According to GSMA, 9% of Africans still lack mobile network coverage, and only 28% use mobile internet, restricting the reach of digital health solutions. Skill shortages, limited data availability, regulatory uncertainties, and challenges around diversity, equity, inclusion, and algorithmic bias further complicate implementation.
CEIMIA highlighted that for AI to be effective and sustainable, projects must address local context, infrastructure constraints, and the need for collaboration between public and private stakeholders. Scaling initiatives beyond urban centres will require targeted investment in connectivity, training, and community engagement.
Looking ahead
The Horizon 1000 programme is designed to demonstrate the practical impact of AI in strengthening primary healthcare systems while preparing for broader adoption across the continent. By leveraging advanced technologies, the Gates Foundation and OpenAI aim to improve health outcomes, reduce the burden on overstretched medical staff, and expand access to essential services.
Officials said the programme will monitor outcomes closely during the pilot in Rwanda, generating insights that can inform policy and future investment. If successful, the initiative could serve as a model for AI-enabled healthcare interventions across Africa, showing how technology can complement human expertise rather than replace it.
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With sub-Saharan Africa’s population continuing to grow and demand for healthcare rising, digital solutions such as AI may become essential tools for meeting the continent’s health challenges, particularly in areas where human resources and infrastructure are scarce.
