Rwanda is among the first African countries set to benefit from a new $50 million artificial intelligence (AI) healthcare initiative spearheaded by the Gates Foundation in partnership with OpenAI, aimed at strengthening primary healthcare delivery across the continent.
The programme, known as Horizon 1000, was announced by Bill Gates, co-chair of the Gates Foundation, in a blog post published on Wednesday. The initiative aims to roll out AI-powered tools across 1,000 primary healthcare clinics and surrounding communities by 2028, working closely with African governments and health-sector leaders.
Gates said the project is designed to respond to critical workforce shortages in sub-Saharan Africa, where millions of people lack access to adequate healthcare services. The region faces an estimated shortfall of nearly 6 million healthcare workers, a gap that Gates noted cannot be closed solely through training and recruitment.
“These shortages place an enormous burden on existing health workers,” Gates wrote, noting that technology can help ease pressure on overstretched systems.
Under the Horizon 1000 programme, AI solutions will be introduced at the clinic, community, and household levels to support, not replace, health workers. The tools are expected to assist with disease diagnosis, improve the allocation of limited resources, and strengthen decision-making across health systems.
Rwanda’s growing role in digital health innovation was highlighted in the announcement. Gates referenced remarks by Rwanda’s Minister of Health, Dr Sabin Nsanzimana, who recently unveiled an AI-powered Health Intelligence Centre in Kigali as part of the country’s 4×4 health sector reform agenda. The centre is designed to improve efficiency by using real-time data to guide policy and clinical decisions.
Dr Nsanzimana has previously described artificial intelligence as a transformative force in medicine, ranking it alongside vaccines and antibiotics in terms of impact, a position Gates said aligns with his own views.
The Gates Foundation has already supported several AI-driven health projects across Africa, while Rwanda has positioned itself as a regional leader in health digitisation. In April 2025, the country launched the National Health Intelligence Centre (NHIC) AI Lab, housed within the National Health Study Centre, to harness real-time health data to improve patient outcomes, optimise health financing, and drive innovation.
Rwanda’s digital health ecosystem integrates data from community health workers, health centres, and hospitals, ensuring that accurate, up-to-date data inform clinical and policy decisions. At the community level, the Community Electronic Medical Records (cEMR) system has replaced multiple paper-based registers, significantly improving data capture and reporting.
At primary and secondary care levels, platforms such as E-Ubuzima and E-Fiche track patients throughout their medical journey, from first contact to discharge, feeding comprehensive data into the NHIC for national-level analysis.
With Horizon 1000 set to launch its pilot phase in Rwanda, officials say the initiative could further strengthen the country’s use of AI to expand access, improve efficiency, and support frontline health workers.
