Standing before thousands in Nelson Mandela Hall at the African Union headquarters, Bill Gates delivered a pointed call to action. In a speech aimed squarely at African leaders, the Microsoft co-founder and philanthropist urged governments to harness innovation and prioritize public health—despite economic headwinds and shifting global aid priorities.
“I recently made a commitment that my wealth will be given away over the next 20 years,” Gates said. “The majority of that funding will be spent on helping you address challenges here in Africa.”
The pledge is part of a sweeping plan by the Bill Gates Foundation to spend $200 billion over the next two decades. The bulk of that, Gates confirmed, will go to Africa.
The event brought together more than 12,000 people—including diplomats, health workers, development partners, and youth leaders—both in person and online. Gates emphasized the role of African leadership in charting a course for the continent’s future.
“By unleashing human potential through health and education,” he said, “every country in Africa should be on a path to prosperity—and that path is an exciting thing to be part of.”
Gates later joined the foundation’s Africa director, Dr. Paulin Basinga, for a fireside chat focused on development priorities, the shifting aid landscape, and strategies for deepening impact through local partnerships.
That theme—shared responsibility and collaboration—was echoed by several African leaders. Dr. Ngozi Okonjo-Iweala, Director-General of the World Trade Organization, pointed to past progress and insisted it had not come by accident.
“Africa’s health progress is a result of strong government leadership, resilient communities, and partnerships that deliver results,” she said.
Mrs. Graça Machel, a longtime advocate for women and children, described the current moment as fragile but not without hope.
“This is a moment of crisis,” Machel said. “Mr. Gates’ long-standing partnership with Africa reflects a deep understanding of these challenges and a respect for African leadership, ideas and innovation. We are counting on Mr. Gates’ steadfast commitment to continue walking this path of transformation alongside us.”
Gates, who has worked in Africa for more than two decades, pointed to specific countries—Ethiopia, Rwanda, Zimbabwe, Mozambique, Nigeria, and Zambia—that are showing what can happen when leadership meets ingenuity. He cited examples ranging from expanded health access and frontline services, to real-time data systems that help drive down child mortality.
“What we’ve learned,” Gates said, “is that helping the mother be healthy and have great nutrition before she gets pregnant, while she is pregnant, delivers the strongest results. Ensuring the child receives good nutrition in their first four years as well makes all the difference.”
He zeroed in on the importance of primary healthcare: “Investing in primary healthcare has the greatest impact on health and wellbeing.”
Gates also addressed the potential of artificial intelligence to reshape healthcare in Africa, describing a continent already ahead of the curve in mobile banking and poised to do the same in digital health.
“I’m seeing young people in Africa embracing this,” he said, referring to AI. “And thinking about how it applies to the problems that they want to solve.”
He held up Rwanda as a case in point. “Rwanda is using AI to improve service delivery,” Gates said. “AI-enabled ultrasound to identify high-risk pregnancies earlier, helping women receive timely, potentially life-saving care.”
This week, Gates is visiting Ethiopia and Nigeria—two countries grappling with the realities of shrinking international aid. In Ethiopia, he met with Prime Minister Abiy Ahmed and sat down with the Ethiopian Public Health Institute to discuss the country’s initiative to introduce iodine-folic acid double-fortified salt.
“Our foundation has an increasing commitment to Africa,” Gates said. “Our first African office was here in Ethiopia about 13 years ago. Now we have offices in South Africa, Kenya, Nigeria, and Senegal. That’s a great way for us to strengthen partnerships.”
From Addis Ababa, he will head to Nigeria to meet with President Bola Ahmed Tinubu and other leaders, participate in a Goalkeepers Nigeria event on innovation, and hear from scientists helping shape the country’s national AI strategy.
Gates’s trip follows the foundation’s May 8 announcement of its unprecedented 20-year, $200 billion commitment—a final push to make lasting progress before it sunsets its operations. The foundation’s focus will remain on three big goals: ending preventable maternal and child deaths, wiping out deadly infectious diseases, and helping lift millions out of poverty.
Since its earliest engagements on the continent, the Gates Foundation has worked with African partners to strengthen health systems and roll out vaccines. Its backing helped fuel the work of Gavi, the Vaccine Alliance, and the Global Fund, contributing to what it says are more than 80 million lives saved globally.
Reflecting on the long road so far, Gates sounded a note of admiration, and humility.
“I’ve always been inspired by the hard work of Africans even in places with very limited resources,” he said. “The kind of field work to get solutions out, even in the most rural areas, has been incredible.”
