The Chairman of the Gates Foundation, Bill Gates, has admonished African leaders to utilise the foundation’s $200bn pledge to accelerate health and development progress through innovation and partnership, despite current challenges.

According to a release by the Gates Foundation, he pledged that the majority of his foundation’s $200bn expenditure over the next 20 years would be directed towards Africa, concentrating on collaborations with governments that prioritise the health and well-being of their citizens.

“I recently made a commitment that my wealth will be given away over the next 20 years. The majority of that funding will be spent on helping you address challenges here in Africa,” he asserted.

Speaking to over 12,000 government officials, diplomats, health workers, development partners, and youth leaders both in person and online, Gates emphasised the vital role of African leadership and creativity in shaping the continent’s health and economic future.

“By unleashing human potential through health and education, every country in Africa should be on a path to prosperity – and that path is an exciting thing to be part of,” he said.

The Microsoft founder stressed the need to prioritise primary healthcare, emphasising, “Investing in primary healthcare has the greatest impact on health and wellbeing. With primary healthcare, what we have learned 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.”

According to Gates, countries like Ethiopia, Rwanda, Zimbabwe, Mozambique, Nigeria, and Zambia are showing what is possible when bold leadership harnesses innovation.

“From expanding frontline health services and using data to cut child mortality to deploying advanced tools against malaria and HIV, and safeguarding primary healthcare despite fiscal strain—these country-led efforts are driving scalable, homegrown progress,” he added.

Reflecting on more than two decades of engagement on the continent, Gates said, “I’ve always been inspired by the hard work of Africans even in places with very limited resources.” adding, “The kind of fieldwork to get solutions out, even in the most rural areas, has been incredible.”

Gates spoke about the transformative potential of artificial intelligence, noting its relevance for the continent’s future.

He praised Africa’s young innovators, saying he was “seeing young people in Africa embracing this, and thinking about how it applies to the problems that they want to solve”. He added, “Africa largely skipped traditional banking and now you have a chance, as you build your next-generation healthcare systems, to think about how AI is built into that.”

He pointed to Rwanda as an early example of this promise, noting, “Rwanda is using AI to improve service delivery. E.g. AI-enabled ultrasound, to identify high-risk pregnancies earlier, helping women receive timely, potentially life-saving care.”

“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.”

Meanwhile, at the event, the Director-General of the World Trade Organisation, Dr Ngozi Okonjo-Iweala, emphasised that Africa’s health progress was a result of strong government leadership, resilient communities, and partnerships that deliver results.

Also, a renowned advocate for women and children, Mrs Graça Machel, described the current situation as “a moment of crisis” and emphasised the importance of enduring partnerships in Africa’s development journey.

“Mr Gates’ long-standing partnership with Africa reflects a deep understanding of these challenges and a respect for African leadership, ideas and innovation,” she said. “We are counting on Mr Gates’ steadfast commitment to continue walking this path of transformation alongside us.”

According to the foundation, this week, Gates visited Ethiopia and Nigeria to observe the current state of health and development priorities following recent cuts to foreign aid.

It disclosed that he reaffirmed his commitment, as well as that of the foundation, to support Africa’s progress in health and development over the next 20 years.

While in Ethiopia, Gates met with Prime Minister Abiy Ahmed and heard how Ethiopia is sustaining the momentum on critical reforms, expanding essential services, and remaining resilient amid shifting global aid dynamics.

Gates also took part in a roundtable with the Ethiopian Public Health Institute on the country’s iodine-folic acid double-fortified salt initiative.

In Nigeria, Gates will be meeting with President Bola Tinubu and engaging with federal and state leaders to discuss Nigeria’s primary health care reforms.

He is also expected to participate in a Goalkeepers Nigeria event focused on Africa’s innovation future and meet with local scientists and partners shaping Nigeria’s national AI strategy and scaling up health solutions.

Gates’s trip follows the foundation’s historic announcement on May 8 that it would spend $200bn over the next 20 years to advance progress on saving and improving lives and Gates’ commitment to giving away virtually all of his wealth to the foundation in that timeframe.

Over the last two decades, the Gates Foundation has worked alongside African partners to save lives, develop vaccines, and strengthen systems.

It has helped catalyse more than 100 innovations and contributed to saving more than 80 million lives through Gavi and the Global Fund to Fight AIDS, Tuberculosis, and Malaria.