The Rachman Review Bill Gates: AI, aid cuts and the fear of speaking out
29 snips
Jan 29, 2026 
Bill Gates, Microsoft co-founder and philanthropist focused on global health and tech, discusses aid cuts and why philanthropy cannot replace government funding. He outlines a $50m OpenAI collaboration to bring AI into 1,000 African clinics and talks about AI aiding non-doctors and disrupting jobs. He also reflects on a climate of fear in US business and his past meetings with Jeffrey Epstein.
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Child Mortality Rapidly Improved Then Reversed
- Child mortality fell dramatically from over 10 million to 4.6 million by 2024, largely due to vaccines and basic public health.
- Gates warns recent donor cuts and disrupted primary care caused a rise to 4.8 million and risk reversing progress.
Philanthropy Can't Replace Government Aid
- The Gates Foundation's planned 20-year spending will not replace sovereign aid budgets like the US $40bn a year.
- Gates stresses philanthropy can't substitute for government resources and calls for stabilising public aid.
Collect Local Data Before Deploying AI
- Use AI to augment frontline health workers by transcribing consultations and integrating local medical data.
- Collect and share African language datasets so model providers can improve performance for local dialects.