The Gates Foundation and OpenAI have announced a US$50 million partnership aimed at accelerating the use of artificial intelligence in healthcare delivery across sub-Saharan Africa, in a move designed to address chronic shortages of medical workers and improve access to quality care.
The initiative, known as Horizon 1000, will focus on deploying AI-powered tools in 1,000 primary healthcare clinics by 2028. The programme is jointly funded by the Gates Foundation and OpenAI, combining financial support with technical expertise to integrate AI into everyday clinical settings.
Bill Gates, writing on his Gates Notes blog, described artificial intelligence as a “game changer” for global health, arguing that it has the potential to close long-standing equity gaps in access to medical services. He said the initiative reflects the foundation’s core principle that transformative technologies should reach developing regions without the decades-long delays that have historically accompanied innovation.
The rollout will begin in Rwanda, where AI tools will be tested in clinics through close collaboration with government authorities and health professionals. Rwanda was selected as the pilot country due to both its openness to digital innovation and the severity of its healthcare workforce shortage. The country currently has about one healthcare worker per 1,000 people, far below the World Health Organization’s recommended ratio of four per 1,000. Gates noted that, at current training and recruitment rates, closing this gap could take as long as 180 years.
Under Horizon 1000, AI systems will be used to support frontline health workers rather than replace them. The tools are expected to assist with clinical decision-making, patient record management, triage, and administrative tasks, allowing healthcare staff to spend more time with patients. Gates emphasised that similar technologies are already easing workloads for clinicians in wealthier countries and could have an even greater impact in under-resourced settings.
Rwanda’s Minister of Health, Dr Sabin Nsanzimana, has described artificial intelligence as the third major medical breakthrough after vaccines and antibiotics, a view Gates echoed during the initiative’s launch. He said AI could help solve “generational challenges” that were previously impossible to tackle due to weak infrastructure and limited human resources.
The urgency behind the programme is underscored by the scale of the healthcare workforce crisis in sub-Saharan Africa. The region faces a shortfall of nearly six million healthcare workers, forcing overstretched staff to manage high patient volumes with limited support and outdated clinical guidance. According to the World Health Organization, poor quality of care contributes to between six million and eight million deaths each year in low- and middle-income countries.
The Gates Foundation said it will spend the coming years working with African governments, health institutions, and local innovators to adapt AI tools to on-the-ground realities. Gates also announced plans to visit the region to observe the early deployment of the technology and assess its impact firsthand.
If successful, Horizon 1000 could mark a significant shift in how emerging technologies are used to strengthen health systems in developing regions, positioning AI as a practical tool for improving care delivery rather than a distant or abstract innovation.
