Kigali, Rwanda – Rwanda has emerged as the first African country selected for a landmark $50 million artificial intelligence healthcare initiative, a decision complementary to years of deliberate investment in technology-driven development and health system reform.
Backed by the Gates Foundation and OpenAI, the program, known as Horizon 1000, aims to scale the use of AI across primary healthcare, reaching 1,000 clinics and their surrounding communities across Africa by 2028, with Rwanda serving as the launchpad.
The announcement was highlighted at the World Economic Forum annual meetings on January 21 during a session titled “At the Cusp of Healthcare for All.”
Speaking at the event, Bill Gates underscored the transformative role artificial intelligence can play in health systems, particularly in low- and middle-income countries where shortages of doctors and clinicians remain a persistent challenge.
He said AI tools can significantly improve efficiency by cutting down paperwork, organizing resources, and helping patients better understand when and where to access care.
“The goal is to make the work there [Rwanda] higher quality and, if possible, twice as efficient as it is today, reducing paperwork, organizing resources, and helping patients know what’s available and when to come for appointments,” Gates said.
He added that Rwanda has consistently proven to be a reliable partner for the Gates Foundation across multiple initiatives, making it a natural choice to pilot the program. “So we’re thrilled that it’s the first country this work will go into,” he noted.
Gates also expressed optimism that developing countries could soon leapfrog wealthier nations in healthcare innovation, arguing that urgency and strong government commitment are accelerating adoption.
He said the initiative is expected to expand to other African countries, including Kenya, South Africa, and Nigeria, once lessons are drawn from the initial phase.
Rwanda’s Minister of ICT and Innovation, Paula Ingabire, said the selection aligns with the country’s long-standing strategy of using technology as a catalyst for development.
With limited natural resources, Rwanda has prioritized digital innovation to drive growth and improve public services, including healthcare.
She said the government is already developing decision-support AI tools for more than 60,000 community health workers who form the backbone of primary healthcare delivery nationwide.
The initiative also complements Rwanda’s ongoing 4×4 health reform program, which targets a fourfold increase in the healthcare workforce within four years. Two years into implementation, the country has already achieved 3.8 times its original workforce baseline.
Ingabire said AI will be essential in helping this expanded workforce deliver better care, reduce administrative burdens, and focus on more precise and targeted interventions.
She added that Rwanda has invested heavily in national data intelligence platforms and is assembling high-quality datasets to train AI models that address real health challenges while minimizing bias and ensuring fairness.
While the country plans to develop its own AI models in the future, she said it is currently leveraging open-source models trained on local data and adapted to Rwanda’s context.
Peter Sands, CEO of the Global Fund, described Rwanda as a standout example of what is possible when infrastructure and policy align. He noted that the country has achieved 97 per cent connectivity, a level some wealthier nations have yet to reach.
Sands said this positions Rwanda to adopt AI tools faster than many developed countries, even as he cautioned that gaps in electricity, internet access, and skilled personnel remain a challenge across much of Africa.
Despite these hurdles, the Horizon 1000 initiative signals growing confidence that countries like Rwanda can lead the next wave of healthcare innovation, using artificial intelligence not as a luxury, but as a necessity to deliver care more efficiently and equitably.
