Bill Gates says Africa is leading a new era of innovation and progress

ill Gates, Chair of the Gates Foundation, will be in Ethiopia this week — his first stop in Africa since announcing plans to give away $200 billion through the foundation over the next two decades. In advance of his trip, Capital’s Groum Abate asked Gates to unpack the significance of this announcement and what it could mean for Africa. Excerpts;

Capital: The foundation recently announced it will be sunset by 2045, doubling its spending to $200 billion over the next 20 years. What were the key factors that led to this accelerated timeline?

Bill Gates: The decision to accelerate our timeline reflects a sense of urgency and opportunity at a critical moment.

While the world has made incredible progress in global health and development over the past 25 years, in the last several years we’ve seen African countries face debt burdens, a slow then abrupt pullback in foreign aid, and other shocks that challenge that progress, especially here in Africa. So, rather than preserve the institution indefinitely, the foundation has committed to spend $200 billion to accelerate progress. That’s double what we spent in the past 25 years.

We believe transformative changes are possible, particularly on our three core goals: ending preventable deaths of mothers and children, eliminating deadly infectious diseases, and helping millions lift themselves out of poverty. We won’t achieve all of these completely in the next 20 years, but I think with partnerships and support from governments, the private sector, and other philanthropies, we can go a long way towards saving and improving millions of lives. I’m very excited about that.

Capital: What steps are you taking to ensure progress is sustained after the foundation closes, especially in the areas of child health and infectious diseases?

Bill Gates: We see the next 20 years not as an exit, but a transition to deeper African ownership. The foundation has partnered with African institutions, researchers, and philanthropists for decades. There’s incredible talent and energy on the continent, and we will continue to support that over the next twenty years. In fact, most of the money we spend during that period will have impact in Africa and will have broader impact in the U.S. and globally. Governments and local organizations will carry the work forward long after we are gone.

Africa is experiencing transformative progress powered by innovation and local leadership. AI-enhanced tools like handheld ultrasound are being used to identify high-risk pregnancies, potentially saving up to 2 million mothers’ lives by 2030. Researchers such as Dr. Bosede Afolabi in Nigeria are pioneering maternal health solutions, including IV iron and intrapartum sensors, to ensure safer pregnancies and deliveries. Maternal and child mortality rates have dropped significantly, and countries have seen life expectancy rise due to better healthcare, nutrition, and economic growth—like in Ethiopia, where since 2000, life expectancy has risen from 51 to 67. Immunization coverage is rising in many regions, wild poliovirus has been eradicated on the continent, and Algeria and Cape Verde have eliminated malaria. African nations are also making progress against neglected tropical diseases—Niger recently became the first on the continent to eliminate river blindness.

So many countries are leading their own progress—but this progress is uneven, and now, political and economic headwinds are threatening to reverse it. It will take concerted effort to keep up momentum and extend this progress to the most remote places.

Capital: How are you working to ensure that local philanthropists and scientists in the Global South—particularly in Africa—can carry forward this work and sustain impact amid declining global donor support?

Bill Gates: We recognize that no philanthropic organization, no matter how large, can replace public investment. Our role has always been catalytic: to fund early-stage solutions, build evidence, and support partners who can scale interventions sustainably. But this moment demands more.

We’re doubling down on high-impact investments. Gavi and the Global Fund, which the foundation helped create, have saved more than 80 million lives since 2000. These institutions are entering new replenishment cycles, and we’re urging traditional donors to continue backing them. The foundation is also advocating for greater investment in areas where market forces alone won’t drive the solutions we need, such as malaria eradication, pandemic preparedness, and maternal health

.Over the two decades that we’ve been partnering with African institutions, we’ve seen how philanthropy can act not just as a source of funding, but as a catalyst—offering flexible, risk-tolerant support in areas where markets and governments cannot move quickly or go far enough.

A powerful example is drug discovery: a high-risk, high-reward field largely neglected in Africa due to weak incentives and systemic underinvestment. Africa hosts the smallest share of clinical trials globally, resulting in therapies that often overlook the continent’s specific health needs. Philanthropic support—like the Grand Challenges Africa Drug Discovery Accelerator—has enabled African scientists to lead in discovering new treatments for diseases such as TB and malaria, with innovations rooted in local knowledge and priorities.

The private sector in Africa is also stepping up. Earlier this month, the Africa CEO Forum concluded in Abidjan with a resounding call for deeper public-private collaboration to accelerate the continent’s economic transformation. I understand more than $200 million in investment commitments were announced across critical sectors, including energy, artificial intelligence, and agriculture—clear evidence that Africans are not waiting for others to come in and solve problems, but rather, that shaping those solutions themselves.

Capital: The foundation is known for supporting breakthrough innovations in health and development. How do you balance investing in high-risk, high-reward innovations with supporting the scaling of proven interventions, especially given the new 20-year timeline?

Bill Gates: We’re on the brink of some exciting breakthroughs in fighting TB, which still kills more people annually than HIV or malaria. The first new tuberculosis vaccine in a century is in Phase 3 trials as we speak. Innovations like gene therapy for sickle cell disease and AI-powered diagnostics offer enormous promise, but only if they’re affordable and accessible to all. If a new drug or vaccine is too expensive, it won’t have the impact we need. That’s why we’re partnering with African researchers and experts around the world to drive down costs and innovate creative solutions to long-lasting challenges.

Artificial intelligence is also a key part of our innovation agenda. Across Africa, homegrown tools are bridging critical gaps—like Mkulima GPT,a Swahili chatbot that helps farmers get the best, most up-to-date information and training; EDVES, an AI-powered school management system; and Crop2Cash ,a platform that helps farmers access digital finance and markets.

Capital: How is the foundation using data and partnerships to advance equity, especially in education and health systems?

Bill Gates: Data helps identify where the greatest needs lie and distribute resources effectively. We take a data-first approach to advancing equity, using rigorous evidence to identify where needs are greatest and which interventions deliver the most impact. Across the continent we are working in partnership with a diverse range of partners including government ministries, national universities and public health institutes, national statistical offices, external funders, non-governmental and private sector institutions all aimed at improving the quality, accessibility and use of data that helps identify how different sectors are performing be they immunization, maternal health or simply tracking disease burden.

Without data, countries can end up missing things like disease outbreaks or identifying where the greatest need is or largest gaps in the health system are or learning from those parts of the country that are doing better than others. Good data systems help governments allocate limited resources more efficiently, and we are committed to helping countries sustainably strengthen their data systems. Ethiopia has made great strides in strengthening its own data systems – last time I was here I saw progress made on many fronts including improving shipment data so that the country could track whether the right live saving medicines were available in country. I saw efforts being made to strengthen health facility data so that the government could assess the quality and accessibility of facilities and understand the number of people and type of service being received. I saw investments in your universities and public health institutes that are helping the government analyze and draw insights of complex data. These insights inform more inclusive policies and resource allocation, particularly in underserved communities.

In education, the foundation applies the same commitment to evidence by investing in research and partnerships that elevate solutions proven to improve learning outcomes for historically marginalized learners. It supports the use of education data to assess foundational literacy and numeracy, identify gaps in access and quality, and scale what works

Capital: You have highlighted the power of AI to accelerate positive transformation and development. Can you share examples of how the foundation is investing in AI, and what safeguards are in place to ensure AI is used ethically?

Bill Gates: We’re already seeing AI’s impact in improving the lives of women, children and vulnerable communities. AI enabled x-rays and ultrasounds are increasing access to life-saving medical innovation for people in remote areas who typically lack access to specialist care. Point of care diagnostics and treatment guidance are helping community healthcare workers serve patients more quickly and effectively.

The “Catalyzing Equitable AI Use to Improve Global Health” initiative—supported by the Grand Challenges network, including the Gates Foundation, the South African Medical Research Council, and the Science for Africa Foundation—has backed more than 50 projects across low- and middle-income countries to drive AI-powered solutions to urgent health challenges

.In Nigeria, Dr. Nneka Mobisson, CEO of mDoc Healthcare, is integrating large language models into a digital platform to deliver personalized, culturally grounded health guidance for women, particularly around chronic disease and reproductive health. In South Africa, Professor Lara Fairall is leading the development of AISHA, an AI tool that synthesizes evidence-based clinical recommendations to support better decision-making by frontline health workers. And in Côte d’Ivoire, Rory Assandey is scaling KIKO, a WhatsApp-based AI chatbot that offers young people anonymous access to mental health support and connects them to care.

These innovators are helping to ensure that the benefits of AI are not only cutting-edge, but also inclusive, context-specific, and responsive to local health needs. But of course, we need to be purposeful about making sure AI is used ethically and equitably—by investing in inclusive datasets, supporting local innovation ecosystems, and embedding strong safeguards.

Capital: Finally, is there any progress in Ethiopia that you believe is worth highlighting?

Bill Gates: Over the past two decades, Ethiopia has emerged as an exemplar of progress in health and development. Maternal and child mortality has declined significantly, with under-five mortality reduced by more than two-thirds — driven by investments in primary healthcare, immunization, and a pioneering community health worker program. The country has also made notable gains in HIV prevention and treatment. In agriculture, Ethiopia has improved productivity and food security through stronger extension services, better access to inputs, and investments in rural infrastructure. Financial inclusion has expanded rapidly, bringing banking and digital financial services to millions previously underserved. These achievements reflect Ethiopia’s commitment to investing in its people and offers lessons for other countries in how to prioritize health and developme