DAVOS, Switzerland – The Bill and Melinda Gates Foundation and OpenAI have announced a $50 million partnership aimed at helping African countries strengthen their health systems through artificial intelligence, at a time when international aid to the sector is shrinking.
The initiative, named Horizon1000, was unveiled on Wednesday on the sidelines of the World Economic Forum in Davos, Switzerland. Bill Gates said the programme would work directly with African leaders to decide how artificial intelligence can be applied in public health, starting with Rwanda and later expanding to other countries on the continent.
Speaking to Reuters, Gates said the move comes after global aid reductions last year were followed by the first increase in preventable child deaths this century. He said artificial intelligence could help reverse that trend, particularly in countries facing severe funding constraints. 
International aid cuts began in the United States at the start of 2025 and later extended to other major donors, including Britain and Germany. According to estimates by the Gates Foundation, global development assistance for health dropped by just under 27 percent last year compared to 2024.
AI could play a critical role in countries affected by these cuts, Gates said.
“Using innovation, using AI, I think we can get back on track,” he told Reuters on Wednesday, adding that the technology would revolutionise healthcare.
“Our commitment is that that revolution will at least happen in the poor countries as quickly as it happens in the rich countries.”
For countries such as Eswatini, which continue to manage high burdens of HIV and maternal health challenges alongside limited health personnel, the approach being piloted under Horizon1000 mirrors some of the pressures faced locally, particularly in rural clinics where patient loads remain heavy.
The Gates Foundation has already rolled out several AI focused health initiatives, while Rwanda last year set up an AI health hub in Kigali. Rwanda’s Minister of Information and Communications Technology and Innovation, Paula Ingabire, said the focus is on practical use within the health system.
“It is about using AI responsibly to reduce the burden on healthcare workers, to improve the quality of care, and to reach more patients,” Ingabire said in a video statement released on Wednesday.
Horizon1000 aims to reach 1,000 primary healthcare clinics and surrounding communities across several African countries by 2028. Gates noted that in some countries there is only one doctor for every 50,000 people, even in major urban centres, a situation far removed from ratios seen in high income countries.
He said the initiative is likely to prioritise care for pregnant women and people living with HIV, with AI tools offering guidance before patients arrive at clinics, especially where language differences exist between patients and health workers. Once at the facility, AI systems would help cut down paperwork and improve access to patient histories and appointment records.
“A typical visit, we think, can be about twice as fast and much better quality,” Gates said.
