Bill Gates, Chair of the Gates Foundation, is visiting Rwanda to learn from partners working to strengthen health systems, expand economic opportunity, and advance innovation across the country.
His visit comes at a pivotal moment, as African countries navigate shrinking development assistance, rapid technological change, and growing ambitions for greater economic and health sovereignty.
In advance of his trip, he responded to questions from Godfrey Mutizwa, Editor-in-Chief CNBC Africa.
CNBCA: Rwanda is often cited as a success story and a country that has made strong progress by investing in people, institution-building, innovation, digital transformation. What are you hoping to see and learn in Rwanda and what lessons will be relevant for other African countries?
Bill Gates: What stands out to me is not one particular innovation, but the way the country’s long-term investments in people, strong institutions, and delivery are translating into real progress.
Since 2000, the number of Rwandan children who die before age 5 has fallen by 80 percent, and the number of women who die from complications during pregnancy and childbirth has fallen by 85 percent. Those gains came from years of investment in strengthening primary healthcare, supporting community health workers, and building institutions like the Rwanda Biomedical Center.
I am looking forward to meeting government leaders, frontline health workers, innovators, researchers, and students to better understand how they’re working—individually and together—to improve lives.
CNBCA: Despite constrained fiscal spaces, African governments have been striving to strengthen their health systems; should they rethink funding models for healthcare and education?
Bill Gates: There’s no doubt this is a difficult moment. Development assistance is declining, and governments across the continent are facing hard decisions about how to prioritize their limited ree to invest in the interventions that we know do the greatest good
Investing in primary health care means investing in a country’s greatest re prioritizing these investments. I am looking forward to seeing that in practice here in Rwanda, and learning more about the country’s ongoing investments in primary care, community health workers, prevention, and early treatment—some of the most cost-effective ways to save lives
We’re also seeing countries like Senegal and Zambia establish Health Transformation Units that improve coordination, reduce duplication, and direct limited re
Last year, I announced that the Gates Foundation will invest $200 billion over the next two decades, with the vast majority to benefit Africa. Ultimately, long-term progress will depend on stronger domestic institutions and leadership, which is why our role is to support the priorities African countries have already set for themselves.
CNBCA: You have long suggested investment in people and innovation. Where do you see the greatest untapped opportunities for Africa’s young population over the next decade?
Bill Gates: Africa’s greatest asset is its young people. By 2040, the continent will have the world’s largest working-age population. If countries continue investing in health, education, and innovation, that demographic shift can become one of the greatest economic opportunities of this century.
What makes me optimistic is that the next generation of innovators isn’t waiting for opportunities—they are creating them. Across the continent, young entrepreneurs are building AI applications, financial technologies, health innovations, creative industries, and businesses that will compete globally. In Rwanda, institutions like the University of Global Health Equity and the Rwanda Coding Academy are developing the next generation of scientists and innovators.
Every major technological shift creates new opportunities for people who are ready to build. Africa has already shown that by leapfrogging traditional banking through mobile money. I believe AI, digital public infrastructure, and advances in health and agriculture will create the same opportunity for this generation.
CNBCA: Artificial intelligence is transforming industries worldwide. How can African countries ensure they are not merely consumers of AI but active participants in shaping and benefiting from the technology?
Bill Gates: AI is the biggest technological advancement of our lifetime. It has the potential to help solve some of Africa’s biggest challenges. For example, AI can support teachers with better tools to personalize learning, identify students who are falling behind, and improve foundational skills.
But technology on its own isn’t the answer. AI will only make a difference if it helps people do their jobs better and improves the quality of the services they provide. Whether it’s supporting a nurse to make a better clinical decision, helping a community health worker identify a high-risk pregnancy, or giving a farmer better information, AI should strengthen human capability rather than replace it.
I’ll be writing more about AI soon. But during this trip, I’m eager to meet with health workers, farmers, students, and innovators to learn more about Rwanda’s approach to AI. The National Health Intelligence Center in Rwanda, for instance, is working to connect service data, patient records, supply chain information, insurance claims, workforce data, and civil registration so leaders can make faster and better decisions. The Gates Foundation is working to support those efforts through programs like Horizon 1000, which aims to equip 1,000 primary health clinics with AI tools by 2028.
CNBCA: Several African countries are investing in digital public infrastructure. What are the most important foundations governments need to establish to ensure these systems deliver inclusive economic growth?
Bill Gates: DPI is essential for economic growth. When countries build digital payment and secure data-sharing systems that work together, it becomes easier for people to start businesses, access financial services, and receive government support.
For example, Tanzania’s m-mama model uses dispatch technology to connect pregnant women and newborns to emergency transportation, including community drivers where ambulances are unavailable. So far, this has resulted in more than 150,000 emergency journeys in Tanzania, with more than 6,300 lives saved.
The most important ingredients are trust and inclusion. People need confidence that their data is protected, systems are secure, and everyone will benefit. If digital systems aren’t designed to include women, small business owners, farmers, and people in rural communities, they risk widening inequality instead of reducing it.
This is why the Gates Foundation supports partnerships with organizations like AfricaNenda and Equity Group. These collaborations are focused on helping countries build digital infrastructure in ways that expand financial inclusion, strengthen cross-border payments, and improve people’s lives.
CNBCA: Local manufacturing is increasingly viewed as essential for economic resilience. In which sectors do you believe Africa has the greatest potential to build globally competitive industries?
Bill Gates: COVID reminded the world that resilient supply chains matter just as much as scientific breakthroughs. When countries struggled to access vaccines, syringes, and other essential medical products, it became clear that relying on a handful of manufacturers thousands of miles away creates real risks.
Thankfully, today, African manufacturers are increasingly making medicines, diagnostics, and vaccines themselves. Here in Rwanda, TKMD has produced more than 22 million syringes since 2024, secured a contract with UNICEF to procure 150 million more units, and is on track to cut transport times across East, Central, and Southern Africa by up to 90 percent. In Kenya, Revital Healthcare has shown that African manufacturers can meet the quality standards of global markets, producing everything from auto-disable syringes to diagnostics.
We’re seeing the same progress in essential medicines. Companies like QCIL in Uganda and Cosmos in Kenya have achieved WHO prequalification and secured Global Fund contracts to supply first-line HIV medicines.
Ultimately, this is about much more than manufacturing. It’s about creating good jobs, strengthening Africa’s health security, and driving long-term economic growth.
CNBCA: The Gates Foundation has historically worked closely with governments and multilateral institutions. However, the geopolitical landscape is shifting. Does the current global development architecture require a rethink? How can African leaders ensure that partnerships serve national priorities rather than external interests?
Bill Gates: We have seen what is possible when countries and institutions work together. The Gates Foundation has long supported partnerships like Gavi and the Global Fund because they show what coordinated global action can achieve. Over the past 25 years, these partnerships have helped save some 90 million lives. Child deaths have been cut by more than half globally, HIV deaths have fallen dramatically, and countries across Africa have made extraordinary progress against diseases that once seemed impossible to contain.
But the world is changing. Aid budgets are under pressure, countries face higher borrowing costs, and governments are being asked to do more with less. That means partnerships have to evolve, and it is important to strengthen and support institutions that allow countries to lead their own development.
Across the continent, we’re seeing stronger public health institutions, world class researchers, innovative businesses, and regional organizations taking on a bigger role. The most effective partnerships are those that align behind national priorities—bringing reutions lead the way
