The Gates Foundation and OpenAI announced a $50 million “pilot” on Wednesday to “advance AI capabilities for health” in Africa. Horizon 1000 promises “funding, technology, and technical support” to roll out AI solutions to 1,000 African primary healthcare clinics by 2028.

“AI is going to be a scientific marvel no matter what, but for it to be a societal marvel, we’ve got to figure out ways that we use this incredible technology to improve people’s lives,” said Sam Altman, CEO of OpenAI, in a media release.

“The goal is to make [health care] much higher quality, and if possible, twice as efficient as it is today – taking away the paperwork, organising resources so the patient knows what is available and when to come for their appointments,” Gates Foundation CEO Bill Gates told a session at the World Economic Forum (WEF) in Davos on Wednesday.

Starting with Rwanda 

The pilot will start in Rwanda, and later branch out to Kenya, South Africa and Nigeria, Gates added.

Rwanda is already exploring the use of AI to help health workers with disease diagnosis, relieve them of onerous administrative tasks, and model the trajectory of diseases.

Paula Ingabire, Rwanda’s Minister of Information, Communication and Technology and Innovation, told the WEF that her country has been working on technological solutions for its “pain points” for over two decades.

As a start, the country has rolled out internet access to around 97% of its population – a significant achievement in a country where most people live in rural areas.

It is currently building “some of the foundational digital infrastructure that is enabling and powering [technological] advancements,” said Ingabire.

One of Rwanda’s aims is to use AI to create “decision-support tools” for its 60,000-plus community health workers (CHW) who provide primary healthcare to communities across the country.

As around 70% of the cases CHW deal with every year are malaria, the country wants an AI tool to help them to improve diagnosis and to better anticipate when and where to expect malaria cases, said Ingabire.

Rwanda has already used a combination of drones and AI to address malaria – with the drones pinpointing and spraying mosquito breeding sites and AI helping with the prediction and modelling of the disease.

Two years ago, Rwanda set itself the goal of quadrupling its health workforce in four years – something it has already almost achieved.

“But they’re going to need these tools to support better care delivery. Some of the administrative tasks that they’ve been working on, we can use AI to do that, so they’re more focused on delivering better and targeted care to our people,” Ingabire said.

The government also wants to use AI to improve its demand forecasting for health commodities to prevent medicine stockouts.

“We started this digital transformation journey more than 15 years ago. We have a lot of data that we’re not using. Building national data intelligence platforms that help us is critical. Once we build these models, they need to be trained on our own data, they need to be context specific, and they need to come in to address real problems.”

Ingabire added that her country is also in conversation with the AI company Anthropic, which developed the large language model Claude, “to see how we can have an instant health intelligence platform that then feeds into the entire national health planning systems and allows us to allocate better resources”. 

AI-based TB screening

Peter Sands, CEO of the Global Fund to Fight AIDS, Tuberculosis and Malaria, told the WEF that the fund has invested $170 million over the past four years in AI-based TB screening.

This is one of the largest single applications of AI and health, and it is delivering a “very significant impact”, he added.

One example of how the Fund has used AI-based TB screening is in refugee camps.

“There are well over a million Sudanese refugees in Chad, and we set up mobile clinics with the government of Chad to go into these refugee camps and do screening for TB,” said Sands. 

As there were no radiologists, “if you want the screening to be interpreted, there is no alternative [but AI]”, he added.

However, Sands warned that some “very basic problems” still need to be fixed to enable the rollout of AI-driven solutions – primarily that many African primary health care facilities lack internet connectivity, and some even lack power.

He also urged the use of AI to be “framed around problems needing solutions, as opposed to a whole bunch of tools needing a problem to fix” – akin to people “running around with a whole lot of hammers looking for nails”.

He added that tools are easier to develop than finding people “who can actually use them and make things happen”. 

Faster progress in LMICs than wealthy countries?

Gates believes that there may be faster progress with the rollout of AI in healthcare in developing world health than the “rich world” because “the need is so great, and the governments are embracing this and making sure that it’s moving at full speed”.

“The $50 million commitment is just the beginning. I believe that people in Africa should have this ‘health advisor’ without having to pay anything for it. It should just be a basic capability available to them. 

“As you go into the health system, instead of filling out paperwork and redescribing everything, the AI that you’ve been talking to is summarising that… getting rid of the paperwork together.”

Sands also believes that low- and middle-income countries could adopt AI tools faster than developed economies, which are more regulated and where AI is more likely to take away jobs. 

“One of the reasons this may well take off faster in middle-income countries is because there won’t be the resistance from people who say: ‘This has taken my job’ and ‘I don’t want to change the way we do things’, because it’s compensating for the fact that those people don’t exist.”

Image Credits: Cecille Joan Avila / Partners In Health.