Horizon1000 Initiative

Horizon1000 Initiative is sponsored by Bill & Melinda Gates Foundation, OpenAI. This initiative supports African countries, starting with Rwanda, in applying AI technology to improve their healthcare systems.

The doctor can see you now ## Expanding access to health care through AI Today’s AI can transform health care systems and support health care workers the world over. By Bill Gates published on Wednesday, Jan 21, 2026 A core principle underlying the Gates Foundation’s work is closing the innovation gap between rich countries and everyone else.

People in poorer parts of the world shouldn’t have to wait decades for new technologies to reach them. That’s why we've worked for 25 years to accelerate access to life-saving medicines and vaccines in low- and middle-income countries.

It's also why, today, the Gates Foundation and OpenAI are announcing an initiative called Horizon1000 to support several countries in Africa, starting in Rwanda, as they apply AI technology to improve their health care systems. Over the next few years, we will collaborate with leaders in African countries as they pioneer the deployment of AI in health.

Together, the Gates Foundation and OpenAI are committing $50 million in funding, technology, and technical support to back their work. The goal is to reach 1,000 primary healthcare clinics and their surrounding communities by 2028.

## Today’s AI can help save lives A few years ago, I wrote that the rise of artificial intelligence would mark a technological revolution as far-reaching for humanity as microprocessors, PCs, mobile phones, and the Internet. Everything I’ve seen since then confirms my view that we are on the cusp of a breathtaking global transformation.

All over the world, AI, in the form of LLMs and machine learning models, are improving far more quickly than I first anticipated. From science to education to customer service and more, AI tools are reshaping every facet of our lives. I spend a lot of time thinking about how AI can help us address fundamental challenges like poverty, hunger, and disease.

One issue that I keep coming back to is making great health care accessible to all—and that’s why we’re partnering with OpenAI and African leaders and innovators on Horizon1000. ## Not enough doctors in the house We have seen amazing successes in global health over the past 25 years: child mortality has been cut in half, and there are now real pathways to eliminating or controlling deadly diseases like polio, malaria, TB, and HIV.

But one stubborn problem that keeps slowing progress is the desperate shortage of health care workers in poorer parts of the world. In Sub-Saharan Africa, which suffers from the world’s highest child mortality rate, there is a shortfall of nearly 6 million health care workers, a gap so large that even the most aggressive hiring and training efforts can’t close it in the foreseeable future.

These huge shortages put health care workers in these countries in an impossible situation. They’re forced to triage too many patients with too little administrative support, modern technology, and up-to-date clinical guidance.

Partly as a result, the WHO estimates that low-quality care is a contributing factor in 6 to 8 million deaths in low- and middle-income countries every year, and that’s not even counting the millions who die because they aren’t able to access health care _at all_. Today’s AI can help save those lives by reaching many more people with much higher-quality care.

Rwanda currently has only one health care worker per 1,000 people, far below the WHO recommendation of about four per 1,000. It would take 180 years for that gap to close at the current pace of progress.

So, as part of the 4x4 reform initiative, Minister of Health Dr. Sabin Nsanzimana recently announced the launch of an AI-powered Health Intelligence Center in Kigali to help ensure limited health care resources are being used as wisely as possible. As part of the Horizon1000 initiative, we aim to accelerate the adoption of AI tools across primary care clinics, within communities, and in people’s homes.

These AI tools will support health workers, not replace them. Minister Nsanzimana has called AI the third major discovery to transform medicine, after vaccines and antibiotics, and I agree with his point of view. If you live in a wealthier country and have seen a doctor recently, you may have already seen how AI is making life easier for health care workers.

Instead of taking notes constantly, they can now spend more time talking directly to you about your health, while AI transcribes and summarizes the visit. Afterwards, AI can handle much of the onerous paperwork, so doctors and nurses can focus on the next patient. In poorer countries with enormous health worker shortages and lack of health systems infrastructure, AI can be a gamechanger in expanding access to quality care.

I believe this partnership with OpenAI, governments, innovators, and health workers in sub-Saharan Africa is a step towards the type of AI we need more of: systems that help people all over the world to solve generational challenges that they simply didn’t know how to address before. I invite others working on AI to think about how we can put these massively powerful tools to the best use.

This announcement is a great example of why I remain optimistic about the improvements we can make. I’m looking forward to seeing health workers using some of these AI solutions in action when I visit Africa, and I plan to continue focusing on ways AI technology can help billions of people in low- and middle-income countries meet their most important needs.