The Gates Foundation and OpenAI are collaborating to test the use of artificial intelligence (AI) in primary healthcare systems across parts of Africa. This initiative comes amid growing strain on healthcare systems due to rising demand, chronic staff shortages, and shrinking international aid budgets. ## Horizon1000: AI for Basic Healthcare The collaboration between the Gates Foundation and OpenAI supports a new initiative, Horizon1000, which aims to introduce AI tools into primary healthcare clinics across several African countries. The project will begin in Rwanda and is intended to reach 1,000 clinics and surrounding communities by 2028, supported by a combined $50 million investment. The main goal is to assist with everyday tasks that consume time in under-resourced clinics. AI tools are expected to assist with patient intake, triage, record keeping, appointment scheduling, and access to medical guidance, particularly in settings where one doctor may serve tens of thousands of people. ## AI as Support, Not Replacement Both the Gates Foundation and OpenAI emphasize that the focus is on supporting healthcare workers rather than replacing them. OpenAI is expected to provide technical expertise and AI systems, while the Gates Foundation will work with African governments and health authorities to oversee deployment and alignment with national guidelines. Rwanda was chosen as the first pilot country in part because of its existing digital health efforts. The country established an AI health hub in Kigali and has positioned itself as a testbed for health technology projects. The goal is to reduce administrative burdens while expanding access. ## What the AI Tools Will Do AI tools may also be used before patients reach clinics, supporting pregnant women and HIV patients with guidance ahead of visits, especially when language barriers exist. Once patients arrive, AI could help link records, reduce paperwork, and speed up routine processes. The Horizon1000 initiative represents a test of whether AI can play a useful, limited role in primary care without overstating its reach. The outcome will depend less on the technology itself than on how well it fits into the systems meant to use it.