[KAMPALA, SciDev.Net] When Bill Gates stood before the African Union and pledged to commit the majority of his foundation’s US$200 billion wealth over the next two decades to Africa, the announcement sent ripples across the continent.

The Microsoft co-founder and global philanthropist said the money would target primary health care, artificial intelligence (AI), vaccine development, and education — sectors critical to Africa’s development.

“The majority of that funding will be spent on helping you address challenges here in Africa,” Gates told African leaders in Addis Ababa last month (2 June).

The pledge comes at a time of deep anxiety in Africa, as donor aid shrinks and health systems strain under funding cuts, notably from the United States and United Kingdom.

While many welcomed the renewed commitment, public health officials and policymakers say its true impact will hinge on whether it supports Africa’s long-standing push for independence, in vaccine production, data governance, and the development of homegrown AI tools.

“This support must go beyond service delivery,” said Daniel Kyabayinze, Director of Public Health at Uganda’s Ministry of Health.

“It must build Africa’s capacity to manage its own future.”

He added that while donor funding has saved lives, African nations now need investments in infrastructure and manufacturing capacity to reduce dependency.

“We can’t rely indefinitely on the goodwill of others,” he said.

Eric Arts, a professor of microbiology at Western University in Canada who has worked on HIV research in Uganda for over 20 years, agreed. “Spread across Africa, $200 billion is still a finite amount,” he said.

“The key is how it is used. For too long, we’ve depended on medicines made elsewhere, even in countries that aren’t high-income.”

Arts believes investment in African manufacturing could be a game-changer.

“If we had vaccine production capacity here, we wouldn’t wait five to ten years for life-saving treatments. We could become suppliers, not just recipients, just like India and China.”

Bill Gates spotlighted AI as a key part of the strategy, citing Rwanda’s maternal health innovation as a model.

But experts warn that if Africa is not in control of the data and technology, AI could become the next frontier of dependency.

“The goal should not just be AI,” said Kyabayinze.

“It must be African-built AI, governed locally and trained on African data.”

Jim Arinaitwe, a public health policy expert at Uganda’s Makerere University, agreed that countries need to develop new technologies for themselves.

“Instead, we end up bringing in experts from abroad to run this AI revolution in our countries. It will keep us dependent for centuries,” he said.

According to Arinaitwe, Africa’s young population is one of its greatest assets in the AI era, but only if equipped with the right skills and tools.

“The majority of our people — the young innovators, scientists, and even ordinary citizens —don’t know how to use AI. It’s a new revolution that Africa has just stepped into,” he told SciDev.Net.

He urged the Gates Foundation to focus on skills and capacity-building:

“Gates should equip the young ones in this programme, train them.

“Africa has not used even one per cent of what the rest of the world is doing with AI. We need to become the experts, not import them.”

A key part of Gates’ plan is boosting AI across healthcare, agriculture, and education.

But according to Ritesh Ajoodha, an AI consultant and professor at the University of the Witwatersrand in South Africa, Africa’s shortage of AI experts is a fundamental barrier that must be addressed early.

“We need a strategy to reap the benefits of AI. Young people think it is just searching and asking AI questions, but we need expertise that can show us how to apply it in agriculture, health, and businesses, not just Google searches,” Ajoodha said.

He says the success of AI in Africa depends on building local technical skills, robust data systems, and clear ethical frameworks, “grounded in African realities”.

“Our young experts are at the forefront of this movement but need support,” he said.

“Africa also needs to understand the ethical considerations of AI whereby establishing regulations that promote disclosure and transparency is crucial for addressing ethical concerns.

“Much of Africa’s AI potential will need locally relevant innovations, disease diagnostics, and these require community-led governance frameworks, not tech imports.”

While Gates outlined a strong focus on diseases like TB, HIV, and malaria, Arts urged that non-communicable diseases be included in the plan.

“We are having so many cancer cases, diabetes, sickle cell, these should be added to the priorities,” he said.

“Sadly even when such diseases get any breakthroughs, Africa will take a decade or two to get this medication.”

Arinaitwe noted that researchers in Africa are getting closer to developing vaccines for HIV and other diseases and need the last-mile support, training, funding, and infrastructure.

Gates announced plans in May to close the foundation by 2045 — a decade earlier than originally planned.

But many health policymakers warn that if this is to be the final act, the foundation must leave the continent more self-sufficient than it found it.

“The opportunity is enormous,” said Arts.

“With the right investments in infrastructure and human capital, Africa can shift from being a passive recipient to a global leader in health innovation.”

This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.