The Gates Foundation and OpenAI are launching a new partnership aimed at bringing artificial intelligence into frontline health care systems across Africa, starting with Rwanda.

The initiative, called Horizon1000, will deploy AI-powered tools to support primary health care workers in patient intake, triage, follow-up, referrals, and access to trusted medical information in local languages. The organizations said the effort is designed to augment — not replace — health workers, particularly in regions facing severe workforce shortages.

The Gates Foundation and OpenAI are committing up to $50 million in combined funding, technology, and technical support, with a goal of reaching 1,000 primary health clinics and surrounding communities by 2028. The tools will be aligned with national clinical guidelines and optimized for accuracy, privacy, and security, according to the organizations.

“I spend a lot of time thinking about how AI can help us address fundamental challenges like poverty, hunger, and disease,” Bill Gates wrote in a blog post. “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.”

In sub-Saharan Africa alone, health systems face a shortage of nearly six million workers — a gap Gates said cannot be closed through training alone.

“AI offers a powerful way to extend clinical capacity,” wrote the Microsoft co-founder.

The announcement comes during the World Economic Forum’s 2026 annual meeting, where Gates appeared alongside Rwanda’s Minister of ICT and Innovation and the head of the Global Fund to discuss how AI and other technologies could help reverse recent setbacks in global health outcomes.

OpenAI, backed by Microsoft, earlier this month rolled out ChatGPT Health as part of its foray into healthcare.

Other nonprofits are exploring ways to apply AI in healthcare. PATH, a Seattle-based global health nonprofit, has received funding from the Gates Foundation to support this work. That includes grants to develop diagnostics and other healthcare services targeting underserved populations in India, and funding to study the accuracy and safety of AI-enabled support for healthcare providers.

Previously: Gates Foundation will cut up to 500 positions by 2030 to help reach ‘ambitious goals’

The Gates Foundation on Wednesday unveiled a record $9 billion operating budget for 2026 — which includes a plan to reduce its workforce by up to 500 positions over the next five years, or about a fifth of its current headcount.

The foundation’s board approved a cap on operating expenses of no more than $1.25 billion annually — roughly 14% of its total budget — prompting the cuts and other cost controls to align internal spending with that new limit.

The Seattle-based foundation said headcount targets and timelines will be adjusted year by year, and that it will continue to hire selectively for roles deemed critical to advancing its mission.

The decision comes after the foundation announced last year that it would shut down by 2045.

Bill Gates, the Microsoft co-founder who helped launch the Gates Foundation in 2000, announced plans in May to give away $200 billion — including nearly all of his wealth — over the next two decades through the foundation.

The philanthropy is the world’s largest and has already disbursed $100 billion since its founding, helping save millions of lives with its focus on global health and other social initiatives.

“The foundation’s 2045 closure deadline gives us a once-in-a-generation opportunity to make transformative progress, but doing so requires us to focus relentlessly on the people we serve and the outcomes we want to deliver,” Mark Suzman, CEO of the Gates Foundation, said in a statement. “Ensuring as much of every dollar as possible flows toward impact is critical to achieving our ambitious goals to save and improve millions more lives over the next 20 years.”

The foundation had already begun ramping up its grant making, issuing $8.75 billion in 2025, and previously committed to distribute $9 billion this year. It has a $77 billion endowment.

This year the foundation will increase spending in priority areas, including maternal health, polio eradication, U.S. education, and vaccine development.

The increase in funding commitments comes amid Trump administration cuts to global foreign assistance, its shutdown of the U.S. Agency for International Development (USAID), and broader reductions in funding for health and scientific research.

In his annual letter released last week, Gates wrote that “the thing I am most upset about” is that the number of deaths of children under 5 years old increased in 2025 for the first time this century, which he traced to cuts in aid from rich countries.

“The next five years will be difficult as we try to get back on track and work to scale up new lifesaving tools,” he wrote. “Yet I remain optimistic about the long-term future. As hard as last year was, I don’t believe we will slide back into the Dark Ages. I believe that, within the next decade, we will not only get the world back on track but enter a new era of unprecedented progress.”

— Jon Pollock is now chief product officer of Acumatica, the Bellevue, Wash.-based enterprise software giant that was acquired last year by Vista Equity Partners.

Pollock joins Acumatica from childcare management software company Procare Solutions, where he was CPO and general manager of Procare’s ChildPlus division. He previously held leadership roles with Worldpay, Asurion, Dell, Polaroid and others.

“Jon has the experience, vision, and strong track record of leading dynamic teams to execute our product strategy and empower the people who use our software every day,” John Case, CEO of Acumatica, said in a statement.

Case succeeds Ali Jani, who was with the company for 16 years. Early in his career, Jani co-founded a PC manufacturing startup and a company providing software for business management operations.

— Mo Malakoutian is now the mayor of the City of Bellevue. Malakoutian joined the Bellevue City Council in 2023, was elected by his colleagues to serve as deputy mayor beginning in 2024, and was chosen as mayor this month.

Malakoutian previously worked at Amazon for more than eight years, leaving the role of senior manager of learning and development in October. He is currently the executive director of the University of Washington’s Consulting and Business Development Center with the Foster School of Business.

Malakoutian replaces Lynne Robinson, who was mayor since 2020. She remains on the Bellevue City Council.

City councilmember Dave Hamilton was appointed deputy mayor of Bellevue.

— Software engineering leader David Bettis is leaving Amazon after two decades. Bettis was most recently with Amazon Web Services, including roles focused on the company’s telehealth initiative. Earlier in his career, Bettis worked on the company’s Halo product, Amazon Go’s cashierless “Just Walk Out” technology, Kindle and other initiatives.

Bettis said on LinkedIn that he stayed at Amazon for so long because of the opportunity to work on emerging businesses, which provided “new and exciting opportunities, while staying under the same roof.”

More recently he had “explored a couple paths internally, but nothing sparked the same excitement I’d felt in previous roles. That’s when I realized it was time for a bigger change.”

The engineer added that he’ll spend most of this year deciding what full-time role comes next — maybe a smaller company, teaching, something entrepreneurial — and that he’ll be staying in Seattle.

— In another Amazon departure, Steven Hatch has resigned from his role as head of engineering with AWS Bedrock. Hatch, based in New York City, has been with Amazon for nearly 18 years, working in areas including with Audible, Amazon Prime delivery experience, computer vision and most recently in AI.

Hatch said on LinkedIn that he’s “closing a chapter that changed how I think, lead, and build. I’m proud of my achievements. But the real story was about the people, the learning, and the craft.”

Hatch did not disclose his next move, but said there would be “more soon.”

— Warren McNeel left T-Mobile after more then 25 years with the Bellevue-based telecom juggernaut. McNeel has been in the wireless sector for three decades, and most recently served as T-Mobile’s senior vice president of information technology.

McNeel said on LinkedIn that he wanted to spend time with his family “and begin thinking about the next chapter of my professional journey.”

“I’ve had the privilege of leading some of the best technology and product teams in the industry,” he added. “I couldn’t be more proud of the innovations, technology transformations, and results these teams delivered.”

— Seattle-based Gates Foundation appointed Sri Mulyani  Indrawati to its governing board. Indrawati was Indonesia’s first female minister of finance and the former managing director and chief operating officer of the World Bank.

“She adds fresh perspective for the board as it guides the foundation’s direction over the next 20 years,” said CEO Mark Suzman.

The Gates Foundation announced two additional leadership changes:

• Hari Menon is now president of the organization’s Global Growth and Opportunity Division. Menon has been with the foundation for nearly 20 years.
• Ankur Vora is president of the newly-created Africa and India Offices Division as well as retaining his role as chief strategy officer.

— Reverb, a Seattle-based HR consulting and leadership development firm, is officially expanding into the Colorado market with the hiring of Renee Fischer. Fischer, who resides in Denver, is a business development and human resources consultant.

— Sabah Öney joined the board of directors of Seattle’s Fred Hutch Cancer Center. Öney is the president and CEO of Dispatch Bio, a Bay Area startup that is developing a treatment for solid tumors. He is also a co-founder of the protein design company Vilya.

— Seattle-based Cascadia Capital, an investment bank serving clients globally, promoted Kerri Hagen to managing director within the its Financial Sponsors Group. Hagen has been with the firm for more than three years.

— Seattle software engineering startup FlintLab named Diwakar as its head of engineering. Diwakar, who was previously based in India, joins from the semiconductor company AMD. Past employers include Ericsson, RSA Security and others.

FlintLab launched in 2024 and describes itself as an “AI-powered infrastructure platform as a service” company. Co-founders Krishna Seerapu and Jinesh M.D previously held roles at Amazon and elsewhere.

— Life Science Washington announced four new members of its board of directors:

• Arden Yang, vice president of Innovation at the Allen Institute
• LisaMarie Curda, a partner focused on audit and assurance with Deloitte
• Jie D’Elia, CEO of the bio-pharmaceutical company SystImmune
• Chris Holt, vice president of cell therapy external manufacturing with Bristol Myers Squibb

Bill Gates had a front-row seat for the rise of AI, from his longtime work at Microsoft to early demonstrations of key breakthroughs from OpenAI that illustrated the technology’s potential. Now he’s urging the rest of us to get ready.

Likening the situation to his pre-COVID warnings about pandemic preparedness, Gates writes in his annual “Year Ahead” letter Friday morning that the world needs to act before AI’s disruptions become unmanageable. But he says that AI’s potential to transform healthcare, climate adaptation, and education remains enormous, if we can navigate the risks.

“There is no upper limit on how intelligent AIs will get or on how good robots will get, and I believe the advances will not plateau before exceeding human levels,” Gates writes.

He acknowledges that missed deadlines for artificial general intelligence, or human-level AI, can “create the impression that these things will never happen.” But he warns against reaching that conclusion, arguing that bigger breakthroughs are coming, even if the timing remains uncertain.

He says he’s still optimistic overall. “As hard as last year was, I don’t believe we will slide back into the Dark Ages,” he writes. “I believe that, within the next decade, we will not only get the world back on track but enter a new era of unprecedented progress.”

But he adds that we’ll need to be “deliberate about how this technology is developed, governed, and deployed” — and that governments, not just markets, will have to lead AI implementation.

More takeaways from the letter:

Job disruption is already here. He says AI makes software developers “at least twice as efficient,” and that disruption is spreading. Warehouse work and phone support are next. He suggests the world use 2026 to prepare, citing the potential for changes like a shorter work week.

Bioterrorism is his top AI concern. Gates warns that “an even greater risk than a naturally caused pandemic is that a non-government group will use open source AI tools to design a bioterrorism weapon.”

Climate will cause “enormous suffering” without action. Gates cautions that if we don’t limit climate change, it will join poverty and infectious disease in hitting the world’s poorest people hardest, and even in the best case, temperatures will keep rising.

Child mortality went backward in 2025. Stepping outside AI, Gates calls this the thing he’s “most upset about.” Deaths for children under 5 years old rose from 4.6 million in 2024 to 4.8 million in 2025, the first increase this century, which he traced to cuts in aid from rich countries.

AI could leapfrog rich-world farming. Gates predicts AI will soon give poor farmers “better advice about weather, prices, crop diseases, and soil than even the richest farmers get today.” The Gates Foundation has committed $1.4 billion to help farmers facing extreme weather.

Gates is using AI for his own health. He says he uses AI “to better understand my own health,” and sees a future where high-quality medical advice is available to every patient and provider around the clock.

AI is now the Gates Foundation’s biggest bet in education. Personalized learning powered by AI is “now the biggest focus of the Gates Foundation’s spending on education.” Gates says he’s seen it working firsthand in New Jersey and believes it will be “game changing” at scale.

Read the full letter here.